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LIBRARY OF CONGRESS. 



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UNITED STATES OF AMERICA. 



GUIDE TO THERAPEUTICS 



MATERIA MEDIOA. 



BY 



ROBERT FARQUHARSON, M.D. Edin., 

F.R.C.P. Lond., 

LATE LECTUKER ON MATERIA MEDTCA AT ST. MARY'S HOSPITAL 
MEDICAL SCHOOL, ETC. 



THIRD AMERICAN EDITION, REVISED BY THE AUTHOR 



ENLARGED AND ADAPTED TO THE U. S. PHARMACOPOEIA 



BY 

FRANK WOODBURY, M.D., 

PHYSICIAN TO THE GERMAN HOSPITAL, PHILADELPHIA. 







Wl 1882 J / 

^*W« 111 



PHILADELPHIA: 

HENRY C. LEA'S SON & CO. 

1882. 



1> 






Entered according to the Act of Congress, in the year 1882, by 

HENRY C. LEA'S SON & CO., 
in the Office of the Librarian of Congress. All rights reserved. 



COLLINS, PRINTER. 



EDITOR'S PREFACE 



There is no more encouraging evidence of progress 
in medical science than the growing desire of the 
profession for exact information concerning the action 
of remedial agents. A tendency towards empiricism, 
springing from too exclusive a reliance upon clinical 
observation, finds its natural correction only in in- 
creased familiarity with ascertained facts respecting 
the influence of drugs upon the human system in 
health and disease ; and no argument is needed to 
show that if therapeutics is ever to attain the pre- 
cision of a science it must be based upon the fullest 
attainable knowledge of this kind ; indeed, it may 
truly be said that therapeutics, in so far as it is a 
science, owes its position to bio-chemistry, and a 
knowledge of the physiological action of drugs. 

The present volume is an intelligent effort to pre- 
sent, in moderate compass, such well-digested facts 
concerning the physiological and therapeutical action 
of remedies as are reasonably established up to the 
present time. By a convenient arrangement the cor- 
responding effects of each article in health and disease 
are presented in parallel columns, not only rendering 
reference easier, but also impressing the facts more 
strongly upon the mind of the reader. 

In the first American edition very considerable ad- 
ditions were found desirable to adapt it thoroughly 
to the wants of the American student — additions 
that seemed to warrant the insertion of the words 



IV EDITOR S PREFACE. 

" Materia Medica " in the title-page. Without alter- 
ing the peculiar features of the original, some changes 
were then made in the arrangement, and Yery copious 
notes introduced, embodying the latest revision of the 
U. S. Pharmacopoeia, together with the antidotes to 
the more prominent poisons, and such of the newer 
remedial agents as seemed necessary to the complete- 
ness of the work. All matter thus added will be 
found distinguished from the text by brackets [ ]. 

The acceptance of these modifications by the author, 
and his very conscientious revision of the whole, have 
rendered unnecessary any considerable additions by 
the editor in the present edition. He has, however, 
thought it advisable to introduce the Metric System 
in addition to the old form of writing prescriptions, 
in deference to the demands of scientific progress and 
uniformity of observation. A ready reference table 
of Poisons has been placed at the end of the book, and 
in the text itself the tests of the prominent poisons 
have been inserted. It is hoped that the very care- 
ful revision and additions that have been made to 
the Avork (which have increased its size nearly one- 
third) have proportionately enhanced its value to the 
student. 

In a compendious volume like the present, refer- 
ence to many authorities would be out of the ques- 
tion, but the editor must especially acknowledge his 
indebtedness to the excellent National Dispensatorv 
of Drs. Stille and Maisch, Dr. Wood's Therapeutics 
and Materia Medica, Dr. Griffith's Formulary, and 
especially to the clinical teachings of Professors Da - 
Costa and Barthoiow. 

Philadelphia, Oct. 15, 1882. 



AUTHOR'S PREFACE 



THIRD AMERICAN EDITION 



A third edition of my little book having been 
called for with flattering promptitude, I have great 
pleasure, as on a former occasion, in co-operating with 
Dr. Frank Woodbury, and hope that our united ex- 
ertions will be found to have kept this volume fairly 
up to the progress of all. At the same time, I may 
note that the past two years have been by no means 
fertile, either in the purely scientific gains from ex- 
perimental research, or in the more directly practical 
form of knowledge derived from clinical experience 
and observation. An unusually small number of new 
drugs have been introduced, and but scanty addition 
made to our understanding of the properties of those 
which we already possess, so that in my revision of 
the following pages, comparatively little alteration 
has been required. Such a lull is by no means un- 
natural after the great beneficial activity recently 
shown in the field of Therapeutics ; and as scientific 
exactness of method gradually brings the other 
branches of the healing art nearer towards perfection, 
we may be sure that the actual drug treatment of 
disease will assume the precision toward which it is 
now advancing with slow but sure steps. 

A* 



vi author's preface to third edition. 

I cannot help thinking that, important although 
the services are, which have been rendered by the 
purely experimental method, what we now require 
more urgently, are numerous and carefully conducted 
observations on a very wide scale of the action of re- 
medial agents on the human subject in health and 
disease. Any one who runs through our medical 
periodicals cannot fail to see the great danger of gen- 
eralizing on insufficient data, or rushing into print 
with conclusions derived from a very small number 
of cases, and the contradictory nature of the evidence 
thus furnished, is most perplexing to the minds of 
compilers desirous of furnishing to their readers an 
accurate summary of all real and solid progress. 

The attempt to harmonize individual observation 
by means of committees, and the circulation broad- 
cast of elaborate schedules, to be no less elaborately 
filled up, has seldom proved successful, as "the trans- 
actions of many of our learned societies conclusively 
show, and so far as the medical profession, at least, is 
concerned, the special circumstances under which 
work is carried on make it quite evident, that it is far 
better to leave each man to carry out that work for 
himself. The rigid rules for investigation now so 
carefully laid down, and the necessity for .the use of 
modern instruments of precision will always insure 
that any observations conceived in a scientific spirit 
will also be carried out with that accuracy which can 
alone inspire confidence, and Ave would enlist not only 
hospital physicians, but also those who are enabled to 
work the wide and most valuable field of family 
practice, in the cause of careful Therapeutic investi- 
gation. 



author's preface to third edition. vii 

In conclusion, I may say that it was with some 
hesitation I accepted Mr. Lea's kind offer, to become 
responsible for another introduction of my " guide" 
to the American public, as my retirement from active 
professional work may seem to deprive my labors of 
any slight authority they may ever have seemed to 
possess. But I could not resist the temptation of 
telling my friends and readers on the other side of the 
Atlantic once more how sincerely I thank them for 
their cordial appreciation of what little I have done 
for the furtherance of a cause which we all have very 
near at heart, and which is intimately bound up 
with almost every phase of development of scientific 
medicine. 

23 Brook Street, Grosvexor Square, London, 

April, 1882. 



PREFACE 



FIRST EDITION 



In these clays of profuse publication, a preface 
coming from any one who ventures to write a text- 
book must assume, in great measure, an apologetic 
tone. Elaborate and comprehensive works on Thera- 
peutics now crowd our shelves, and the question may 
not unnaturally arise, What excuse can be given for 
adding another item to the rapidly increasing list? 
In reply to this I can only express a hope that room 
may be found for a smaller handbook than those more 
elaborate treatises which reflect so faithfully the pro- 
gress of modern science, and that my little bark may 
float peacefully by the side of more richly laden ves- 
sels without being entirely submerged by their waves. 
I cannot, of course, expect either to supersede or to 
rival the classical manuals of Ringer, Wood, and 
others, and all I aim at is to present the subject in 
briefer compass, in perhaps 'more systematic form, and 
unencumbered by any botanical or pharmaceutical 
detail. 



X PREFACE TO FIRST EDITION. 

Space has not enabled me to acknowledge the 
sources from which I have been enabled to compile 
the following pages; and I can only express in general 
terms my grateful sense of the labors of many able 
and industrious workers in the field of Therapeutics. 
I have freely drawn much valuable material from the 
systematic works of Stille, Neligan, Grarrod, Einger, 
"Wood, Bartholow, Phillips, Thorowgood, Nothnagel, 
Eoyle, and Christison ; and I have also derived im- 
portant instruction from the writings of Brunton, 
Handfield Jones, Fraser, Fothergill, John Harley, 
Anstie, Broadbent, Liebreich, and many others who 
have contributed important aid to the progress of our 
subject in later years. 

For many of my prescriptions I am more especially 
indebted to Bartholow, and to the very handy little 
"Lessons on Prescribing" by Dr. Hansell Griffiths. 

23 Brook Street, Grosvexor Square, W. 
April, 1877. 



CONTENTS. 



Introduction 


. 25 


The Routes by which Medi- 




cines ENTER THE SYSTEM 


. 26 


External Mode of Applica 




tion 


. 26 


(c/) Epidermic method 


. 26 


(b) Endermic " 


27 


(c) Hypodermic " 


27 


(d) Intravenous injection 


28 


Internal Administration 


28 


(a) By inhalation . 


28 


(6) By enemata 


. 28 


(c) By the mouth 


30 


General Rules for Pre 




scribing 


. 30 


Preliminary considera- 




tions 


. 30 


Combination of Drugs 


. 32 


Form of Administration 


. 34 



Proper time for Exhibi- 
tion . . . .34 
Dosage . . . .36 
Interval between Doses . 38 
Individual Peculiarities . 38 
Idiosyncrasy: Habit . 38 

Constitutional or Toxic 

Eifect from Small Doses 41 
Chemical and Physiologi- 
cal Incompatibilities . 42 
Prescribing for Children . 45 
Prescription-writing . 48 

Weights and Measures . 48 
Observations upon Doses . 49 
General Rule for Doses • 50 
General Plan of Arrange- 
ment . . . .51 
The Metric System in Medi- 
cine . . . .54 



SECTION I 



Remarks on certain Classes of Remedies. 



Acids 55 

Anesthetics . . .58 
Anthelmintics . . .59 
Artidotes . . . .61 
Antipyretics and Refriger- 
ants . . . .63 
Antiseptic and Disinfect- 
ants . . . .66 
Astringents and Caustics 68 
Counter-Irritants * . 69 
Diaphoretics . . .70 
Diuretics . . . .71 



Emetics .... 

Emmenagogues and Ecbulics 

Expectorants 

Narcotics and Anodynes . 

Purgatives 

Stimulants and Sedatives . 

Tonics .... 

Summary of the Action of 
Therapeutic Agents . 

Cliniuo-Physiological Clas- 
sification of Drugs 



73 
75 
76 
78 

80 

84 
80 



91 



Xll 



CONTENTS. 



SECTION II. 

Remedies comprised in the Primary List op the United States 
Pharmacopoeia and their Preparations. 

Those preparations marked * are not officinal. 



Absinthium 
Acacia . 

Syrupus Acacise 

Mucilago Acacise 
Acetum . 

Acetum Destillatum . 
Acidum Acetic dm 

Acidum Aceticum Dilutum 
Aceta . 
Acidum Arseniosum . 
Acidum Carbolicum Impur. 
Acidum Carbolicum 

Glyceritum Acidi Carbolici 

Unguent. Acidi Carbolici 

Supposit. Acidi Carbolici 

Aqua Acidi Carbolici 
Acidum Chromicum 
Acidum Citbicum 

Syrupus Acidi Citrici 
Acid. Galltcum (see Galla) 
Acid. Hydrocyanicum Dil. 

Argenti Cyanidum . 

Hydrargyri Cyanidum 

Ferri Ferrocyaniduui 

Potassii Cyanidum . 

Potassii Ferrocyanidum 
Acidum Lacticum 

Ferri Lactas 
Acidum Muriaticum . 

Acid. Muriat. Dilut. 
Acidum Nitricum 

Acidum Nitricum Dilut. 
Acidum Nitro-Muriaticum 

Acid. Nitro-Muriat. Dilut. 
Acidum Oxalic um 

Ferri Ox alas 
Acid. Phosphoric. Glaciale 

Acid. Phosphor. Dilut. 
Acidum Sulphuricum . 

Acid. Sulphuric. Aromat 

Acid. Sulphuric. Dilut. 
Acidum Sulphurosum . 
Acidum Tannicum 

Unguent. Acidi Tanuici 



93 
93 
93 
93 
94 
94 
94 
94 
96 
96 
96 
96 
96 
96 
96 
96 
100 
101 
101 

102 
102 
102 
102 
102 
102 
107 
107 
107 
107 
109 
109 
110 
110 
111 
111 
112 
112 
112 
112 
112 
115 
115 
115 



Glyceritum Acidi Tannici 


115 


, Suppositoria Acidi Tannic 


116 


Trochisci Acidi Tannici 


116 


Acidum Tartaricum . 


116 


Ferri et Ammonii Tartras 


116 


Pulveres Effervescentes 


116 


Pulv. Efferv. Aperientes 


116 


Acidum Valerianicum 


117 


Ammonii Valerianas 


117 


Quinine Valerianas . 


117 


Zinci Valerianas 


117 


Morphias Valerianas* 


117 


Acida 


117 


xlCONITUM . 


118 


Aconiti Folia . 


118 


Aconita Radix . 


118 


Aconitia . . . 


118 


Extractum Aconiti . 


118 


Emplastrum Aconiti . 


118 


Linimentum Aconiti . 


118 


Tinctura Aconiti liadicis 


118 


Adeps 


123 


Unguentum 


123 


Ceratum . 


123 


^Ether 


124 


iEther Fortior . 


124 


Spiritus iEtheris Comp. 


124 


.ZEtherea . 


127 


Alcohol 


127 


Alcohol Dilutum 


127 


Alcohol Fortius 


127 


Vinum Xericum 


127 


Vinum Portense 


127 


Spiritus Vini Gallici 


127 


Spiritus Fruinenti 


127 


Spiritus Myrcioe 


127 


Spiritus Genevse 


127 


Spiritus iEtheris Comp. 


135 


Spiritus /Etheris Nitrosi 


135 


Alcohol Amylicum 


136 


Ammonii Valerianas 


136 


Quiniaa Valerianas . 


136 


Allium 


136 


Syrupus Allii . 


136 



CONTENTS. 



Xlll 



Aloe .... 
Aloe Barbadensis 
Aloe Capeusis . 
Aloe Socotrina 
Aloe Purificata 
Pilulse Aloes 
Pil. Aloes et Assafcetidae 
Pilulae Aloes et Mastiches 
Pilulae Aloes et Myrrhae 
Pilulse Rhei Composit83 
Pulvis Aloes et Canellae 
Tinctura Aloes 
Tinctura Aloes et Myrrhse 
Tinct. Benzoini Composita 
Vinum Aloes . 
Suppositoria Aloes . ' 

Althaea .... 

Alumen . . . 
Alumen Exsiccatum . 

Aluminii et Potass. Sulphas 

Aluminii Sulphas 

Ammoniacum 

Mistura Amraoniaci . 
Pilulse Scillae Compositae . 
Emplastrum Ammoniaci . 
Emp. Am. cum Hydrarg. . 

Ammonia . 

Aqua Ammoniae Fortior . 
Aqua Ammoniae 
Linimentum Ammoniae 
Liquor Ammonii Acetatis 
Spiritus Ammoniae . 
Spirit. Ammon. Aromat. . 
Tinct. Guaiaci Ammoniata 
Tinct. Valerianae Ammon. 
Alumen . 
Ammonii Benzoas 
Ammonii Bromidum . 
Ammonii Carbonas . 
Ammonii Cliloridum 
Ammon. Chlor. Purificat. . 
Ammonii Iodidum 
Ammonii Nitras 
Ammonii Sulphas 
Ammonii Valerianas 
Cuprum Ammoniatum 
Ferri et Ammonii Citras . 
Ferri et Ammonii Sulphas 
Ferri et Ammonii Tartras 
Hydrarg. Ammoniatum 

Amygdala . 

Amygdala Amara 



137 
137 
137 
137 
137 
137 
137 
137 
137 
137 
137 
1.37 
137 
137 
138 
138 
139 
139 
139 
141 
141 
141 
141 
141 
141 
141 
141 
141 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
142 
147 
147 



Amygdala Dulcis . .147 

Mistura Amygdalae . . 147 
Oleum Amygdalae Amarae . 147 
01. Amygdalae Expressum 147 
Aqua Amygdalae Amarae . 147 
Syrupus Amygdalae . . 148 

Unguentum Aquae Rosae . 148 

Amylum . . . .148 

Angustura . . .148 

Anisum .... 149 
Aqua Anisi . . . 149 
Oleum Anisi . . . 149 
Spiritus Anisi . . .149 

Anthemis . . . .149 
Infusum Anthemidis . 149 

Oleum Anthemidis . . 149 

Antimonium . . .149 

Antimonii Sulphuretum . 149 
Antimonii Oxidum . . 149 
Antimonii et Pot. Tartras 149 
Antimonium Sulpburat. . 150 
Antimonii Oxysulpburet. . 150 
Pil. Antimonii Compositae 150 
Vinum Antimonii . . 150 
Emplastrum Antimonii . 150 
Unguentum Antimonii . 150 
Syr. Scillae Compositus . 150 

Aqua ..... 155 
Aqua Destillata . . 155 

Aquae .... 160 

Argkntum .... 160 
Argenti Cyanidum . .160 
Argenti Nitras , . 160 

Argenti Nitras Fusa . 161 

Argenti Oxidum . . 161 

Arnica . . . .162 
Extractum Arnicae . .162 
Emplastrum Arnicae . 162 

Tinctura Arnicae . .162 

Arsenicum . . .164 

Acidum Arseniosum . 164 

Arsenici Iodidum . . 164 
Liq. Arsen. et Hyd. Iod. . 164 
Liquor Arsenici Cbloridi . 164 
Liquor Potassii Arsenitis . 164 
Sodii Arsenias . . 164 

Liquor Sodii Arseniatis . 164 

ASSAFCETIDA . . . 171 

Mistura Assafcetidae . 171 

Tinctura Assafcetidae . 171 

Pilulae Assafcetidae . . 171 

Pil. Aloes et Assafcetidae . 171 



CONTENTS. 



Suppositoria Assafcetidas 
Empln strum Assafcetidas 
Pilulas Galbani Composite 

Aurantium 

Aurantii Amari Cortex 
Aurantii Dulcis Cortex 
Aurantii Flores 
Aqua Aurantii Florura 
Syrupus Aurantii Florum 
Confect. Aurantii Corticis 
Syrupus Aurantii Corticis 
Tinctura Aurantii 
Infusum Gentianas Comp. 
Tinctura Gentianas Comp. 
Tinctura Cinchonas Comp. 

Aven.e Farina 

Balsamum Peruvianum 

Balsamum Tolutanum 
Syrupus Tolutanus . 
Tinctura Tolutana . 
Tinctura Benzonii Comp. 

Barii Carbonas . 
Barii Chloric! um 
Liquor Barii Chloridi 

Belladonna 

Belladonnas Folia 
Belladonnas Radix 
Tinctura Belladonnas 
Extractum Belladonnas 
Ext. Belladonnas Alcoholic 
Ext. Bellad. Radicis Fluid 
Emplastrum Belladonnas 
Unguentum Belladonnas 
Suppositoria Belladonnas 
Atropia . 
Atropias Sulphas 

Benzoinum . 

Acidum Benzoicum . 
Ammonii Benzoas 
Tinctura Benzoini 
Tinct. Benzoini Composita 
Unguentum Benzoini 

Oleum Bergamii 

Bismuthum 

Bismuthi Subcarbonas 
Bismuthi Subuitras . 

Brominium . 

Ammonii Bromidum 
Potassii Bromidum . 

Buchu 

Ext. Buchu Fluidum 
Infusum Bucha 



171 
171 
171 
172 
172 
172 
172 
172 
172 
172 
172 
172 
173 
173 
173 
173 
173 
174 
174 
174 
174 
174 
174 
174 
175 
175 
175 
175 
175 
175 
175 
175 
175 
175 
175 
175 
184 
184 
184 
184 
184 
184 
185 
185 
185 
185 
186 
186 
186 
187 
187 
187 



Cadmium 

Cadmii Sulphas 
Caffea 
Cajuputi 
Calcium 

Calcii Chloridum 

Calcii Hypophosphis 

Calx 

Calx Chlorinata 

Calcis Hydras . 

Calcii Carbon. Prascipitata 

Calcii Phosph. Prascipitata 

Creta Prasparata 

Hydrargyrum cum Creta . 

Trochisci Cretas 

Mistura Cretas . 

Testa Prasparata 

Liquor Calcii Chloridi 

Liquor Calcis . 

Linimentum Calcis . 

Potassa cum Calce . 
Calumba . 

Ext. Calumbas Fluidum 

Infusum Calumbas 

Tinctura Calumbas . 
Camphora . 

Oleum Camphoras 

Aqua Camphoras 

Linimentum Camphoras 

Linimentum Saponis 

Mistura Chloroformi 

Spiritus Camphoras . 

Tinctura Opii Camphorata 

Cerat. Plumbi Subacetatis 
Canella . 

Pulvis Aloes et Canellas . 

Vinuni Rhei 
Canna . 

Cannabis Amebicana . 

Ext. Cannabis Americanas 
Cannabis Indica 

Extract. Cannabis Indicas. 

Tinctura Cannabis . 
Cantharis . 

Tinctura Cantharidis 

Ceratum Cantharidis 

Ceratum Ext. Cantharidis 

Charta Cantharidis . 

Collod. cum Cantharide . 

Linimentum Cantharidis . 

Emp. Picis cum Canth. 

Unguentum Cantharadis . 



188 
188 
188 
189 
189 
189 
189 
189 
189 
189 
189 
189 
189 
190 
190 
100 
190 
190 
190 
190 
190 
191 
191 
191 
191 
102 
192 
193 
193 
193 
193 
193 
193 
193 
195 
195 
195 
195 
195 
195 
195 
195 
196 
197 
197 
197 
197 
197 
197 
197 
197 
197 



CONTEXTS. 



Capstcum 


. 201 


Infusum Capsici 


. 201 


Oleo-resina Capsici . 


. 201 


Tiuctura Capsici 


. 201 


Caebo ... 


201 


Caebo Ligxi . . - 


. 201 


Carbo Animalis Purificat. 


20 i 


Cardamomttm 


203 


Est. Colocynthidis Comp. 


203 


Pulvis Arornaticus . 


203 


Tinctura Cardamomi 


204 


Tinct. Cardamomi Comp. 


204 


TiDCt. Gentiance Comp. 


204 


Tinctura Rhei . 


204 


Yinum Aloes 


204 


Carum 


204 


Oleum Can 


204 


Tinct. Cardamomi Comp. 


204 


Caryophyllus 


204 


Infusum Caryophylli 


204 


Oleum Caryophylli . 


204 


Cascabilla 


205 


Infusum Cascarilla? . 


205 


Cassia Fistula . 


205 


Cassia Marilandica . 


205 


Castoreum: . 


205 


Tinctura Castorei 


205 


Cataeia 


2( 3 


Catechu 


206 


Infusum Catecliu Comp. 


206 


Tinctura Catechu 


206 


Cerata 


206 


Ckea Alba . 


207 


Cera Flava 


2 ' 


Cerium 


207 


Cerii Oxalas 


207 


Cetaceum . 


207 


Ceratum Cetacei 


207 


Cetraria . 


208 


Decoctum Cetravia? . 


208 


Charts? . 


- 


Chenopodium 


20S 


Oleum Chenopodii 


205 


Chimaphila 


_ - 


Decoctum Chirnaphila? 


_ 


Extract. Chima. Fluidum 


•_ - 


Chiretta . 


9QQ 


Chloral 


- 


Crotou-Cbloral* 


215 


Chlorixoi . 


217 


Aqua Chlorini . 


217 


Chloroform um . 


218 



Chloroformum Yenale 
Chloroform. Purincatum 
Mistura Chloroformi 
Spiritus Chloroformi 
Linimeutum Chloroformi 
Choxdrus . 

ClMICIFDGA . 

Extract. Cimicifugce Flu. 
Cinchona 

Cinchona Flava 

Cinchona Pallida 

Cinchona Rubra 

Cinchonia? Sulphas . 

Decoctum Cinchona? Flava? 

Extractum Cinchona? 

Extractum Cinchona? Flu. 

Infusum Cinchona? Flava? 

Quinia? Sulphas 

Pilula? Quinia? Sulphatis . 

Tiuctura Cinchona? . 

Decoct. Cinchona? Rubra? . 

Infusum Cinchona? Rubra? 

Tinct. Cinchona? Comp. 
Chinoljn* . . . . 

ClNNAMbMUH 

Oleum Cinnamomi 

Tinctura C nuamomi 

Aqua? Cinnamomi 

Pulvis Aromaticas . 

Confectio Aroma tica 

Spiritus Cinnamomi . 
Coccus . . . 

Colchicum . 

Colchici Radix 

Colchici Semen 

Extract. Colcb. Aceticum . 

Ext. Colch. Radicis Fluid. 

Yinum Colchici Radicis 

Ext. Colch. Seminis Fluid. 

Tinctura Colchici 

Yinum Colchici Seminis . 
Collodium . 

Collodium cum Cantharide 

Collodium Flexile 

COLOCYNTHIS 

Extractum Colocynthidis . 
Ext. Colocynthidis Comp. . 
Pilulse Cathartica? Comp. . 
Confectiones . 

CONIUM . 

Couii Folia 
Conii Fructus . 



218 
213 
218 
218 
218 
226 
226 
226 
226 
226 
oor 



227 
227 
227 
227 
227 
227 



237 

23S 
238 
238 
239 
239 
239 
239 
239 
239 
239 
239 
239 
239 
239 
240 
240 
240 
242 
242 
242 
243 
243 
243 
243 
244 
244 
24 4 
244 



XVI 



CONTENTS. 



Ext. Conii Fructus Fluid. 244 

Extractum Conii . . 244 

Ext. Conii Alcoholicum . 244 

Succus Conii . . . 244 

Tinotura Conii . . 244 

Copaiba ■ . . . .248 

Oleum Copaiba . . 248 

Pilule Copaiba . . 248 

Coptis .... 251 

coriandrum . . . 251 

Cornus Florida . . . 252 

Decoctum Cornus Florida 252 

Ext. Corn. Floridae Fluid. 252 

Creasotum .... 252 

Aqua Creasoti . . . 252 

Unguentum Creasoti . 252 

Creta .... 252 

Crocus .... 252 

Cubeba .... 253 

Extractum Cubeba Fluid. 253 

Oleo-Resina Cubeba . 253 

Oleum Cubebse . . 253 

Tinctura Cubeba . . 253 

Trochisci Cubeba; . . 253 

Cuprum .... 253 

Cupri Subacetas . . 253 

Cupri Sulphas . . . 253 

Cuprum .... 253 

Cuprum Ammoniatum . 253 

Decocta .... 256 

Digitalis .... 256. 

Extractum Digitalis . . 256 

Ext. Digitalis Fluidum . 256 

Infusum Digitalis . . 256 

Tinctura Digitalis . . 256 

Digitalinum . . . 256 

Dulcamara . . . 263 

Decoctum Dulcamara . 263 

Extractum Dulcamara . 263 

Ext. Dulcamara Fluidum 263 

Elaterium .... 263 

Elaterium . . . 263 

Elaterin* .... 263 

Emplastra . . . 264 

Ergota . . . .264 

Ext. Ergotse Fluidum . 264 

Vinum Ergotse . . 264 

Ergotine* . , .264 

Erigeron . . . . 269 

Erigeron Canadense . 269 

Ext. Eriger. Can. Fluid. . 269 

Oleum Eriger. Canadensis 269 



ElTPATORIUM 


269 


Infusum Eupatorii . 


269 


Extracta . 


270 


Fermentum 


270 


Ferrum . . . . 


271 


Ferri Hypophospbis 


271 


Ferri Sulphuretum . 


271 


Ferri Cbloridum 


271 


Liquor Ferri Chloridi 


271 


Tinctura Ferri Chloridi 


271 


Ferri Citras 


271 


Liquor Ferri Citratis 


. 271 


Ferri et Ammonii Citras 


271 


Ferri et Ammonii Sulphas 


271 


Ferri et Ammonii Tartras 


271 


Ferri et Potassii Tartras 


271 


Ferri et Quinia Citras 


271 


Ferri et Strychnia Citras 


271 


Ferri Ferrocyauidum 


271 


Ferri Lactas 


271 


Ferri Oxalas . 


271 


Ferri Oxidum Hydratum 


271 


Ferri Phosphas 


271 


Ferri Pyrophosphas 


272 


Ferri Subcarbouas . 


272 


Emplastrum Ferri 


272 


Trochisci Ferri Subcarb. 


272 


Mistura Ferri Composita 


272 


Ferri Sulphas . 


272 


Ferri Sulphas Exsiccata 


272 


Ferrum liedactum . 


272 


Pilula Ferri Carbonatis 


272 


Pilula Ferri Composita 


272 


Pilula Ferri Iodidi . 


272 


Syrupus Ferri Iodidi 


272 


Liquor Ferri Nitratis 


272 


Liquor Ferri Subsulphatis 


272 


Liquor Ferri Tersulphatis 


272 


Potassii Ferrocyanidum 


272 


Ficus .... 


277 


Filix Mas . 


277 


Oleo-resina Filicis 


277 


Fceniculum . 


278 


Oleum Foeniculi 


278 


Aqua Foeniculi 


278 


Galbanum . 


279 


Emp. Galbani Compos. 


279 


Pilula Galbani Composita 


279 


Galla 


279 


Acidum Gallicum 


279 


Glyceritum Acidi Gallici . 


279 


Tinctura Galla 


279 



CONTENTS. 



Unguentum G alios 

Acidum Tannicum, . 

Unguentum Acidi Tannici 

Glyceritum Acidi Tannici 

Suppositoria Acidi Tannici 

Trochisci Acidi Tannici 
Gambogia . 
Gaulthkria 

Oleum Gaultherise . 
Gklsemium . 

Est. Gelsernii Fluidura 
Gextiana . 

Extractum Gentianse 

Ext. Gentianae Fluidura . 

Infusum Gentianae Comp. 

Tinct. Gentianas Comp. 
Geranium . 

Extractum Geranii Fluid. 
Glycerina . 
Glycerita 
Glycyrkhiza 

Ext. Glycyrrhizoa Fluid. . 

Ext. Glycyrrhizae 

Mistura Glycyrr. Comp. . 

Troch. Glycyrr. et Opii. . 
Gossypii Radicis Cortex . 

Ext. Gossypii Rad. Fluid. . 
Gossypium . 

Pyroxylon 

Collodium 

GUAIACUM . . . . 

Guaiaci Lignum 
Guaiaci Resina 
Tinctura Guaiaci 
Tinct. Guaiaci Ammoniata 
Gutta-Percha . 
Liquor Gutta-Perchae 

H^MATOXYLON 

Decoct um Haematoxyli 

Extractum Haematoxyli . 
Hedeojia . 

Oleum Hedeomae 
Helleborus 

Extractum Hellebori 

Tinctura Hellebori . 
Hordeuji . 

Decoctum Hordei 
Humulus . . . . 

Lupulina . 

Ext. Lupulinae Fluidum 

Infusum Humuli 

Tinctura Humuli 



270 
279 
279 
279 
279 
279 
281 
283 
283 
283 
283 
285 
285 
286 
286 
286 
286 
286 
286 
287 
288 
288 
288 
288 
288 
288 
288 
289 
289 
289 
289 
289 
289 
289 
289 
290 
290 
290 
290 
290 
291 
291 
291 
291 
291 
291 
291 
292 
292 
292 
292 
292 



Oleo-Rcsina Lupulinre . 292 
Tinctura Lupulinae . . 292 

Hydrargyrum . . . 292 
Empastrum Amnion, cum 

Hydrar. . . .292 

Emplastrum Hydra rgyri . 292 
Hydrargyrum cum Creta . 292 
Pilulae Hydrargyri . . 292 
Unguentum Hydrargyri . 292 
Hydrarg. Oxid. Rubrum . 292 
Ung. Hydr. Oxidi Rubri . 292 
Hydrarg. Oxidum Flav. . 292 
Ung. Hydr. Oxidi Fiavi . 292 
Hvdr. Sulph. Rubrum . 293 
Hydr. Cbloridum Mite . 293 
Pil. Antimonii Comp. . 293 
Pi!. Catharticae Comp. . 293 
Hydr. Cblor. Corrosivum . 293 
Hydrarg. Ammoniatum . 293 
Ung. Hydr. Ammoniata . 293 
Hydr. Iodidum Rubrum . 293 
Ung. Hydr. Iodidi Rubri . 293 
Liquor Arsenici et Hydrar- 
gyri Iodidi . . .293 
Hydrarg. Iodidum Viride . 293 
Hydrargyri Cyanidum . 293 
Liquor Hydrarg. Nitratis . 293 
Ung. Hydrarg. Nitratis . 293 
Hydrargyri Sulphas Flava 293 

Hydrastis .... 304 
Extract. Hydrastis Fluid. 304 

Hyoscyamus . . . 304 

Hyoscyami Folia . . 304 
Hyosc3 T ami Semen . .. 304 
Extractum Hyoscyami . 304 
Ext. Hyoscy. Alcoholicum 304 
Ext. Hyoscyami Fluidum 305 
Tinctura Hyoscyami . 305 

ichthyocolla . . . 307 

Ignatia . . . .307 
Extractum Ignatiae . . 307 

Infusa .... 307 

Iodinium .... 308 
Tinctura Iodinii . . 308 
Tinctura Iodinii Composita 308 
Liquor Iodinii Compositus 308 
Unguentum Iodinii . . 308 
Ung. Iodinii Compositum . 308 
Liq. Arsen. et Hydrar. lod. 308 
Syrupus Ferri Iodidi . 308 

Pilulae Ferri Iodidi . . 308 

lODOFORMUM . . .310 



IT 



CONTENTS. 



Ipecacuanha . . .311 
Ext. Ipecacuanha Fluid. . 311 
Pulvis Ipecacuanha? Comp. 311 
Trochisci Ipecacuanhas . 311 
Troch. Morph. et Ipecac. . 311 
Syrupus Ipecacuanhas . 311 
Vinum Ipecacuanhas . 311 

Jalapa .... 316 

Extractum Jalapgg . .316 

Pulvis Jalapa? Compositus 316 
Resina Jalapa? . . 316 

Tinctura Jalapa? . .316 

Juglans . . . .317 
Extractum Juglandis . 317 

Juniperus . . . .317 

Infusum Juniperi . .317 

Oleum Juniperi . . 317 

Spiritus Juniperi Compos. 317 
Spiritus Juniperi . .317 

Kino 318 

Tinctura Kino . . .318 

Krameria . . . .318 
Extractum Krameria? . 318 

Ext. Krameria? Fluidum . 318 
Infusum Krameria? . .318 
Syrupus Krameria? . .318 
Tinctura Krameria? . .318 

Lactucarium . . .319 
Syrupus Lactucarii . .319 

Lavandula . . .319 

Oleum Lavandula? . .319 

Spiritus Lavandula? . .319 
Spiritus Lavandula? Comp. 319 

Leptandra . . . .319 

LlMONES .... 320 
Limonis Cortex . . 320 

Limonis Succus . . 320 

Oleum Limonis . . 320 

Acidum Citricum . . 320 
Spiritus Limonis . . 320 

Mistura Potassii Citratis . 320 
Syrupus Limonis . . 320 

Spiritus Ammonia? Arom. 320 
Spiritus Acidii Citrici . 320 

Linimenta . . .321 

Linum .... 321 

Oleum Lini . . . 321 
Lini Farina . . .321 
Infusum Lini Compositum 321 
Oeratum Resina? Compos. 321 
Linimentum Calcis . . 321 

Lithium .... 323 
Lithii Carbonas . . 323 



Lithii Citras 
Lob f.li a . 

Acetum Lobelia 

Tinctura Lobelia? 
Liquores . . • . 
lvcopodium 
Magnesium 

Magnesii Carbonas . 

Magnesii Sulphas 

Magnesia 

Trochisci Magnesia? . 

Liquor Magnesia? Citratis 
Manganesium 

Manganesii Oxid. Nigrum 

Manganesii Sulphas 
Manna .... 

Maranta .... 
Marmor .... 
Marrubium 
Mastiche . 

Pilula? Aloes et Mastiches 
Matico .... 

Extractum Matico Fluidum 
Matricaria 
Mel 

Mel Despumatum 
Mellita .... 
Mentha Piperita 
Mentha Viridis . 

Aqua Mentha? Piperita? 

Oleum Mentha? Piperita? . 

Spiritus Mentha? Piperitse 

Trochisci Mentha? Piperita? 

Aqua Mentha? Viridis 

Oleum Meutha? Viridis 

Spiritus Mentha? Viridis . 
Mezereum .... 

Extractum Mezerei Fluid. 

Unguent um Mezerei 

Decoct. Sarsaparilla? Comp. 

Ext. Sarsap. Comp. Flu d. 
Misturae .... 

MONAHDA .... 

Oleum Monarda? 
Moschus .... 
Mucilagines 
Mykistica .... 

Spiritus Myristica? . 

Oleum Myristica? 

Macis 

Myrrha .... 

Tinctura Myrrha? 

Tinctura Aloes et Myrrha? 



323 
324 
324 
324 
325 
326 
326 
326 
326 
326 
326 
326 



328 
328 
328 
329 
329 
329 
329 
329 
329 
329 
330 
330 
330 
330 
330 
330 
330 
330 
300 
330 
330 
330 
331 
331 
331 
331 
331 
331 
381 
331 
332 
332 
332 
332 
332 
332 
333 
333 
333 



CONTENTS. 



XIX 



Pilule Aloes et MyrrhaB . 833 
Nectandra .... 333 
Nux Vomica . . . 334 

Tinctura Nucls Vomica . 334 
Extractura Nucis Vomicoe 334 
Strychnia . . .334 

Strychnioe Sulphas . . 334 

Glea 338 

Oleo-resinse . . . 339 
Oleum ^Ethereum . . 339 
Oleum Morrhu^s . . 839 

Oleum Oliv^e . . . 342 

Oleum Ricini . . . 343 

Oleum Succini . . . 344 
Oleum Succini Rectificaturn 844 
Oleum Theobromje . . 3 15 
Oleum Thtmi . . . 345 
Oleum Tiglii . . . 345 

Opium 347 

Acetum Opii . . - . 347 
Confectio Opii . . . 347 
Extractum Opii . . 347 

Emplastrum Opii . . 347 
Suppositoria Opii . . 347 

SuppositoriaPlumbi et Opii 347 
Piluloa Opii . . .347 
Pilula Saponis Composita 847 
Pulvis Ipecac. Compositus 347 
Tinctura Opii . . .347 
Tinctura Opii Acetata . 347 
Tinctura Opii Camphorata 347 
Tinctura Opii Deodorata . 347 
Trochisci Glycyr. et Opii . 348 
Trochisci Mofph. et Ipecac. 348 
Liquor Morpbioe Sulphatis 348 
Suppositoria Morphioe . 348 
Vinum Opii . . . 348 
Morphia . . . .348 

Morphioe Acetas . . 348 
Morphias Murias . . 348 

Morphia Sulphas . . 348 
Origanum .... 358 
Oleum Origani . . 358 

Os 358 

Ovum 353 

Papaver .... 358 
Pareira .... 358 
Ext. Pareiros Fluklum . 358 
Infusum Pareiroe . . 358 
Pepo . • . ■ . . 359 

Phosphorus . . . 359 

Physostigma . . . 364 



Eserine* . . . .364 

Extractum Physostigmatis 364 

Pilulee .... 36S 

Pimenta . . . .368 

Oleum Pimentos . . 368 

Piper . . . .368 

Oleo-resina Piperis . . 368 

Pix Burgundica . . . 369 
Emp. Picis Burgundica . 369 
Emp. Picis Cantharide . 369 

Pix Canadensis . . . 369 
Emp. Picis Canadensis . 369 

Pix Liquida . . . 369 

Glyceritum Picis Liquidee 369 
Infusum Picis Liquidoa . 369 
Unguentum Picis Liquidse 369 

Plumbum .... 370 
Plumbi Oxidum . . 370 

Emplastrum Plumbi . 371 

Liquor Plumbi Subacetatis 871 
Liq. Plumbi Subacet. Dil. 371 
Ceratum Plumbi Subacet. 371 
Liq. Plumbi Subacetatis . 371 
Plumbi Acetas . . .371 
Suppositoria Plumbi . 371 

Suppositoria Plumbi et Opii 371 
Plumbi Carbonas . .371 

Ung. Plumbi Carbonatis . 371 
Plumbi Nitras . . .371 
Plumbi Iodidum . . 371 
Unguentum Plumbi Iodidi 371 

Podophyllum . . . 375 
Extractum Podopliylli . 875 
Resina Podophylli . . 375 

Potassium .... 376 
Potassa . . . .376 
Liquor Potassoe . . 376 

Potassa cum Calce . . 376 
Potassii Acetas . . 376 

Potassii Bitartras . . 377 

Antimonii et Potassi Tart. 377 
Ferri et Potassii Tart. . 377 
Potass, et Sodii Tartras . 377 
Potassii Tartras . . 377 
Pulvis Jalapas Compositus 377 
Potassii Bromidum . . 377 

Potassii Carbonas Impura 37 7 
Potassii Carbonas . . 377 
Extractum Spigelioe et 

Sennoc Fluidum . . 377 
Mist. Ferri Composita . 377 
Potassii Bicarbonas . . 377 



CONTENTS. 



Potassii Sulphuretum . 377 
Potassii Carbonas Pura , 377 
Liquor Magnesii Citratis . 377 
Liquor Potassii Arsenitis . 377 
Liquor Potassii Citratis . 377 
Mistura Potassii Citratis . 377 
Potassii Acetas . . 377 

Potassii Chloras . . 377 
Trochisci Potas. Chloratis 377 
Potassii Citras . . 377 

Liquor Potassii Citratis . 377 
Potassii Cyanidum . . 377 
Potassii Ferrocyanidum . 377 
Potassii Hypophospbis . 377 
Potassii Iodidum . . 377 
Potassii Nitras . . 378 

Potassii Permanganas . 378 
Liquor Potassii Permang. 378 
Potassii Sulpbas . . 378 
Pulvis Ipecacuanhas Comp. 378 
Potassii Sutphis . . 378 
Potassii Sulpburetum . 378 
Potassii et Sodii Tartras . 378 
Potassii Tartras . . 378 
Potassii Bicbromas . . 383 
Potassii Bromidum . . 384 
Potassii Iodidum . . 388 

Prunum .... 393 
Prunus Virginian a. . . 393 
Ext. Pruni. Virgin. Fluid. 393 
Infusum Pruni Virginianas 393 
Syrupus Pruni Virginianas 393 
Pulveres . . . .394 
Punica Granatum . . 394 
Granati Fructus Cortex . 394 
Granati Radicis Cortex . 394 
Pelletierine* . . .394 
Quassia .... 395 
Extractum Quassias . . 395 
Infusum Quassias . . 395 
Tinctura Quassias . . 395 
Quercus Alba . . . 395 
Decoctum Quercus Albas . 395 
Quercus Tinctoria . . 395 
Resina . . . .396 

Ceratum Resinas . . 396 

Ceratum Resinas Comp. . 396 
Emplastrum Resinas . 396 

Resinse . . . .396 
Rheum . . . .396 

Extractum Rhei . . 396 
Extractum Rhei Fluidum . 396 



Infusum Rhei . . . 396 
Pilulas Rhei . . .396 

Pilulas Rhei Composite . 396 
Pulvis Rhei Compositus . 396 
Syrupus Rhei . . . 396 
Syrupus Rhei Aromaticus 396 
Tinctura Rhei . . . 397 
Tinct. Rhei et Sennas . 397 

Vinum Rhei . . . 397 

Rosa Centifolia . . 398 

Rosa Gallica . . . 398 
Oleum Rosas . . . 398 
Aqua Rosas . . . 398 

Confectio Rosas . . 398 

Infusum Rosas Comp. . 398 

Mel Rosas . . . 398 

Syrupus Rosas Gallicas . 398 
Unguentum Aquas Rosas . 399 

Rosmarinus . . . 399 

Oleum Rosmarini . . 399 

Rubus .... 399 

Extractum Rubi Fluidum 399 
Syrupus Rubi . . . 399 

Ruta 399 

Oleum Ruta . . .399 

Sabadilla .... 400 
Veratria . . . .400 
Ungueutum Veratrias . 400 

Sabina .... 401 

Ceratum Sabinas . .401 

Extractum Sabinas Fluid. 401 
Oleum Sabinas . . . 401 

Saccharum . . . 402 

Syrupus Fuscus . . 402 

Saccharum Lactis . . 402 

Sago 402 

Salvia .... 403 

Infusum Salvias . . 403 

Sambucus .... 403 

Sanguinaria . . . 403 
Acetum Sanguinarias . 403 

Tinctura Sanguinarias . 403 

Santalum .... 404 

Santonica .... 404 
Santoninum . . . 404 

Trochisci Santonini . . 404 

Sapo 407 

Ceratum Saponis . . 407 
Emplastrum Saponis . 407 

Linimentum Saponis . 407 

Pilula Saponis Composita 407 

Sarsaparilla . . . 407 



CONTENTS. 


XXI 


Decoct. Sarsaparillas Comp 


. 407 


Sodii Arsenias . 


. 417 


Extr. Sarsaparillas Fluid. 


407 


Liquor Sodii Arseniatis . 417 


Ext. Sarsap. Comp. Fluid. 


408 


Sodii Bicarbonas 


. 417 


Syrupus Sarsap. Comp. 


408 


Pulveres Effervescentes . 417 


Sassafras . 


408 


Pulveres Eff. Aperientes . 417 


Oleum Sassafras 


408 


Trochisci Sodii Bicarb. . 417 


Sassafras Medulla 


408 


Sodii Carbonas Exsiccata . 417 


Mucilago Sassafras Medul 


. 408 


Sodii Phosphas 


. 417 


Scammonium 


409 


Liquor Sodas Chlorinatas . 417 


Resin a Scammonii 


409 


Seidlitz Powder 


. 418 


Ext. Colocynthidis Comp. 


409 


Soda Mint 


. 419 


Scilla 


409 


Spigelia 


. 419 


Acetum Scillas . 


409 


Extract. Spigelias Fl 


uidum 419 


Syrupus Scillas 


409 


Extractum Spigelias et 


Pilulse Scilloe Composite? 


409 


Sennas Fluidum 


. 419 


Syrupus Scilloe Composite 


410 


Infusum Spigelias 


. 419 


Tinctura Scillas 


410 


Spiritus 


. 420 


Extractum Scilloa Fluidum 


410 


Spibitus Feumenti 


. 420 


Scoparius . 


410 


Spiritus Myrclx 


. 420 


Senega 


412 


Spibitus Vini Gallici 


. 420 


Decoctum Senegas . 


412 


Statice 


. 420 


Extractum Senegas . 


412 


Stillingia . 


. 421 


Extractum Senegas Fluid. 


412 


Extr. Stillingias Flui 


dum . 421 


Syrupus Senegas 


412 


Stramonium 


. 421 


Senna .... 


413 


Stramonii Folia 


. 421 


Confectio Sennas 


413 


Stramonii Semen 


. 421 


Extractum Sennas Fluidum 


413 


Extr. Stramonii Foliorum 421 


Infusum Sennas 


413 


Extr. Stramonii Semiuis . 421 


Tinctura Rhei et Sennas . 


413 


Tinctura Stramonii 


. 421 


Sebpentabia 


414 


Unguentum Stramonii . 421 


Ext. Serpentarias Fluidum 


414 


Styrax 


. 422 


Infusum Serpentarias 


414 


Succi 


. 422 


Tinctura Serpentarias 


414 


Sulphur 


. 422 


Sevum .... 


414 


Sulphur Lotum 


. 422 


Sinapis Alba 


414 


Sulphur Sublimatum 


. 422 


Sinapis Nigba 


414 


Sulphur Preci pita turn . 422 


Charta Sinapis 


414 


Sulphuris Iodidum 


. 422 


Sodidm .... 


41 G 


Unguentum Sulphur 


s . 422 


Sodii Acetas 


416 


Ung. Sulph. Iodidi 


. 422 


Sodii Bicarbonas Venalis . 


410 


Sodii Hyposulphis 


. 422 


Sodii Boras 


416 


Sodii Sulphis . 


422 


Glyceritum Sodii Boratis . 


410 


Potassii Sulphis 


.' 422 


Mel Sodii Boratis 


416 


Suppositoria . 


. 424 


Sodii Carbonas 


416 


Syrupi 


. 425 


Sodii Chloridum 


410 


Tabagum 


. 425 


Sodii Hypophosphis . 


417 J 


Infusum Tabaci 


. 425 


Sodii Hyposulphis . 


417 


Oleum Tabaci . 


. 425 


Sodii Nitras 


417 I 


Unguentum Tabaci 


. 425 


Sodii Sulphas . 


417 


Vinum Tabaci . 


. 425 


Sodii Sulphis . . 


417 


Tamarindus 


. 427 


Soda . 


417 


Tapioca 


. 4^8 


Liquor Sodas 


417 


Taraxacum 


. 428 



XX11 



CONTENTS. 



Extractum Taraxaci . 428 

Ext. Taraxaci Fluidum . 428 
Infusum Taraxaci . . 428 

Succus Taraxaci . . 428 

Terebintijina . . . 428 
Terebintiiina Canadensis . 428 
Oleum Terebinthinae . 429 

Linimentum Terebinthinae 429 

Testa 431 

Testa Preparata . .431 

Tincturse . . . .432 

Tragacantha . . . 432 

• Mucilago Tragacanthae . 432 

Trochisci .... 433 

Ulmus .... 433 

Mucilago Ulmi . . 433 

Unguenta . . . 433 

Uva Passa .... 434 

Uva Ursi .... 434 

Decoctum Uvae Ursi . 434 

Ext. Uvae Ursi Fluidum . 434 

Valeriana . . . 434 

Extractum Valerianae . 434 

Ext. Valerianae Fluidum . 434 

Infusum Valerianae . . 434 

Oleum Valerianae . . 434 

Tinctura Valerianae . . 434 

Tinct. Valerianae Ammon. 434 ( 



Acidum Valerianicum . 435 

Aramonii Valerianae . 435 

Quiniae Valerianas . . 435 

Zinci Valerianas . . 435 

Vanilla .... 435 

Veratrum Album . . 435 

Veratrum Viriue . . 436 

Ext. Verat. Vir. Fluid . 436 

Tinctura Veratri Viridis . 436 

Vina ..... 437 

Zincum .... 437 

Zinci Oxidum . . . 437 

Zinci Oxidum Venale . 437 

Ung. Zinci Oxidi . . 437 

Zinci Chloridum . . 438 

Liquor Zinci Chloridi . 438 

Zinci Acetas . . . 438 

Zinci Carb. Praecipitata . 438 

Cerat. Zinci Carbonatis . 438 

Zinci Sulphas . . . 438 

Zinci Valerianas . . 438 

Zingiber .... 440 

Ext. Zingiberis Fluidum . 440 

Infusum Zingiberis . . 440 

Oleo-resina Zingiberis . 440 

Syrupus Zingiberis . . 410 

Tinctura Zingiberis . . 440 

Trochisci Zingiberis . . 440 



SECTION III. 

Remedies in Frequent Use, but not included in the Primary 
List, U. S. P. 



Acidum Boracicum 


. 441 


Casca Bark 




452 


Acidum Salicylicum . 


. 442 


Cocculus Indicus 


452 


Sodii Salicylas . 


. 442 


Picrotoxiu 




452 


Ammouii Salicylas . 


• 442 


Curare 




453 


Cinchonidiae Salicylas 


. 442 


Curcuma 




455 


Chinolin Salicylas 


. 442 


Duboisia 




455 


Amyl Nitras 


. 445 


Ethylate of 


Sodium . 


456 


Areca 


. 449 


Eucalyptus Globulus 


456 


Aurum 


. 449 


Oleum Euc 


ilypti Foliorum 


456 


Auri Chloridum 


. 449 


Farina Tritici . 


456 


Auri et Sodii Chloridum 


. 442 


Fel Bovinum 


PURIFICATUM . 


457 


Azedarach 


. 450 


Fuchsine 




457 


Bel^e Fructus 


. 459 


Goa Powder 


• . . 


457 


Brayera 


. 450 


Ingluvin 




458 


Bromide of Ethyl 


. 451 


Jaborandi . 




458 


Ethidene Bichloride . 


. 451 


Pilocarpia 




458 





CONTENTS. 




XXlll 


Pilocarpia Murias 


. 458 


Tinctura Quebracho Com 




Elixir Jaborandis 


. 458 


posita . 




468 


Extractum Jaborandis 




Vinum Quebracho 




468 


Fluidum 


. 458 


Elixir Quebracho 




468 


Liquor Ferri Dialtsatus 


. 468 


Extractum Quebrr 


cho Flu- 




Laricis Cortex . 


. 433 


idum 




468 


Laurocerasi Folia 


. 463 


Resorcin 




479 


Mori Succus 


. 464 


Rhamni Succus . 




470 


MUSCARIN . 


. 464 


Rottlera . 




470 


NlTROGLYCERINUM 


. 464 


Salicin 




470 


Nitrous Oxide Gas 


. 454 


SUMBUL 




471 


Pepsina 


. 465 


Thymol 




471 


Petroleum 


. 466 


Trimethyla'mine . 




471 


Prtroselinum 


. 467 


Trimethylaminis 


Ilydro- 




Quebracho 


. 468 


chlorns . 




471 


Tiuctura Quebracho . 


. 468 


Propylamine 
Leeches 




471 

472 



APPENDIX. 



Poisons 473 

Prompt Treatment of Poisoning ...... 474 

Weights and Measures 481 

Metric System 482 

Relations of Weights of the U. S. P. to Metrical Weights . 483 
Relations of Metrical Weights to Weights of the U. S. P. . 434 
Relations of Measures of the U. S. P. to Metrical Measures . 485 



I 



THERAPEUTICS 



MATERIA MEDICA 



INTRODUCTION. 

Previous to the study of the individual articles com- 
prised within our national Pharmacopoeia, the temptation is 
very strong to launch forth into a disquisition upon the gen- 
eral principles of therapeutics. So many interesting physi- 
ological considerations are involved in the actions and uses 
of drugs, and so many important illustrations might readily 
be drawn from the wide field of practical medicine, that 
little apology would really be needed for consuming some 
of our space in this way. Therapeutics has lately shown a 
systematic vitality which amply redeems its credit from the 
old-fashioned accusation of want of progress, for perhaps in 
no other department of our profession have more solid and 
satisfactory advances been made. But this very condition 
of vigor renders far more laborious and responsible the task 
of attempting to reduce to anything like precision the laws 
on which we are henceforth to prescribe our drugs, or to 
draw complete generalizations from the enormous mass of 
complicated material now at our disposal. Progress occa- 
sionally causes temporary confusion, by disturbing old beliefs 
and furnishing vast legions of sometimes unconfirmed and 
possibly ill-digested facts ; and our present subject is by no 
means exempt from this almost inevitable tendency of true 
science. 

A careful study of the many exhaustive works on thera- 
peutics published within the last twenty years brings before 
us a strange medley of experimental evidence, confusing and 
contradictory it may be at times, but giving most encour- 
3 



26 INTRODUCTION. 

aging proofs of the large amount of honest and persevering 
work now being devoted to the elucidation of this, the most 
important department of practical medicine. In the follow- 
ing pages I must necessarily assume a dogmatic attitude, 
and if the extreme precision with which my plan compels 
me to lay down the actions of drugs offends many whose 
faith is undeveloped or wavering, I can only excuse myself 
by pleading a conscientious desire to contribute something 
towards a more scientific scheme of arrangement. Although 
the time has not yet fully come for a complete explanation 
of all the therapeutical effects of medicinal agents by their 
proved physiological properties, I have ventured to take a 
step in this direction, and must only hope that my very de- 
fects and failures may be of use in helping others to develop 
these principles with greater success. 



THE ROUTES BY WHICH MEDICINES ENTER 
THE CIRCULATION. 

1. External Method of Application. — By this I 
do not mean the merely local action of irritants, caustics, or 
sedatives, but the attempts which we make to utilize the 
absorptive function of the cutaneous surface for therapeutic 
purposes. Now, the shin would, at first sight, seem to be 
a very convenient and tempting arrangement for passing our 
medicines directly into the blood ; but unfortunately for this 
purpose, the vascular cutis vera is protected by the horny 
epidermis, which interposes a very considerable barrier to 
absorption. Much discussion has arisen on this point, and 
it now seems pretty certain that most drugs cannot permeate 
the epidermis readily, if at all, and hence this — (a) the 
epidermic, as it has been styled, or the method by inunction 
— is not of very wide application, save in the administration 
of mercury, which is thus readily admitted, and sometimes 
belladonna and digitalis. Fats and oils, and probably gly- 
cerine, increase our chances of procuring absorption in this 
way, and alcohol may act usefully by dissolving the sebace- 
ous secretion of the skin. 

Chloroform, which has been confidently vaunted as rapidly 
overcoming, by its great diffusive power, the opposition of the 
cuticle to absorption, hardly deserves its reputation, as the 
following experiment will show : after free immersion of my 
finger in a solution of atropia in chloroform (gr. j ad 3j)? 



METHODS OF ADMINISTERING MEDICINES. 27 

not the slightest dryness of the throat or other physiological 
symptom was produced. 

The cuticle, then, being our chief obstacle, it would seem 
an easy matter to overcome the resistance by its removal, 
and indeed this (b) the endermic plan, as it is called, 
has done some good service in therapeutics. Having pro- 
cured a raw surface by blister, we may apply morphia, 
strychnia, or any drug we may wish to use, directly to the 
cutis vera, and thus obtain an undeniably active effect. But 
the process is slow and painful, it may be disfiguring, and 
cannot be very frequently repeated, and it has therefore been, 
justly, almost entirely superseded by (c) the hypodermic 
plan. This, being a rapid, economical, and most efficient 
proceeding, has come into very general use, the principal 
drawback being that the pleasant, soothing influence and re- 
lief from pain which morphia thus gives our patients has 
introduced a form of opium-habit, perhaps hardly less obsti- 
nately adhered to than the older-fashioned form. Unfortu- 
nately, however, not all drugs, nor even all alkaloids, are 
available for this method of administration, as two conditions 
are requisite for success — the fluid to be injected must be 
small in bulk, and it must be unirritating to the parts. 
Chloral has been thus used, but without much success ; 
quinine, though efficient, is unhappily irritating; 1 ergotine 
produces hard, discolored, and painful lumps; mercury often 
causes abscess ; and practically we are almost restricted to 
morphia, atropia, and strychnia, and of these the first named 
is by far the most available. We may refer to a description 
of the way in which the little operation is performed, under 
the subject Opium, remembering always that drugs act three 
or four times more powerfully when given by hypodermic in- 
jection than by the mouth. 

Some authorities advise us to carry these injections boldly 
into the substance of the muscles, and it is said that strych- 
nia thus acts well in some forms of paralysis, but of this I 
have no personal experience. [Deep injections are less lia- 
ble to cause abscess than superficial ones.] 

Then, again, injections may be made directly into the 
veins, and this would, theoretically, seem to be the best, be- 
cause the most straightforward of all methods. We must 
not forget, however, that many drugs require to be acted 

f 1 Several cases have been reported of death from tetanus follow- 
ing the hypodermic injection of quinia.] 



28 INTRODUCTION. 

on by some of the digestive juices before their due therapeu- 
tic powers are developed, and that the dangers of phlebitis, 
thrombosis, and of the admission of air into the veins, with all 
their perilous consequences, cannot be overlooked, (d) Intra- 
venous injection is therefore reserved for very desperate 
cases, and the most notable illustration is in the operation 
for transfusion, by which, after severe hemorrhage, lives 
have undoubtedly been saved. The intra-venous injection 
of chloral, so much praised abroad, has, so far as I know, 
been hardly practised at home. [It has not found general 
favor because it has proved suddenly fatal in several cases.] 

2. Internal Administration 1. Inhalation must 

stand first, on account of the great facility of its application, 
of its remarkable efficiency, and the great purity, so to 
speak, with which drugs thus enter the blood. Anaesthesia 
produced by chloroform, ether, or laughing-gas will occur, 
as the leading example, to every mind, and we know that the 
British Pharmacopoeia lias recently acknowledged the prin- 
ciple by the admission of five vapors — creasote, iodine, 
hydrocyanic acid, chlorine, and conium. But little use, 
however, has yet been made of this tempting channel for th£ 
administration of agents intended to act on the system gene- 
rally, perhaps partly because it is a matter of doubt as to 
how far the delicate structures of the air-cells might be tol- 
erant of the prolonged or repeated contact with possibly 
irritating substances. At present, inhalation has been almost 
confined to the treatment of lung diseases, and ipecacuanha, 
arsenic, stramonium, tannin, and carbolic acid have been 
thus employed; but there is no doubt that this plan is capa- 
ble of much wider development, and that the Germans are 
far ahead of us in this respect. It is evident, however, that 
a barrier must always exist to the very extended adoption of 
aerial medication, by the irritant nature of many medicines, 
and the impossibility of reducing many of them to that 
minute subdivision which is essential for either ordinary in- 
halation or the formation of a readily absorbable spray. 

2. Medicinal agents may be injected into any of the open 
cavities of the body. The rectum is much used in this way, 
and enemata, clysters, or injections as they are called, may 
be divided into three classes. 

a. Purgative Enemata, For efficient and easy evacua- 
tion of the large bowel, no method can compare to this, the 
principal points to remember being that the injection must 



METHODS OF ADMINISTERING MEDICINES. 29 

be ample, from twelve ounces to a pint, must be passed up as 
far as possible, and must be retained as long as the patient is 
able. They may be composed of water alone, of salt and 
water, of gruel or oil, or of any of the purgative enemata 
contained in the Pharmacopoeia (Br.), and their function is 
not only to act mechanically by washing out the contents of 
the lower bowel, but to stimulate its peristaltic movements, 
which they do very efficiently. 

b. Those enemata. which are intended for absorption, and 
which must, therefore, be small in quantity (Jj-ij), so as not 
to excite the expulsive movements of the gut. The princi- 
pal of these is the enema opii, so highly prized on account 
of its restraining influence on the diarrhoea of typhoid and 
phthisis, and on account of the happy way in which it soothes 
pain, not only in the rectum, but, by nervous sympathy, also 
in the neighboring bladder and uterus. Astringents are also 
occasionally used in this way, whilst assafcetida, ipecacu- 
anha, etc., find their special applications, which will be con- 
sidered elsewhere, although we may here lay down the gene- 
ral rule, that drugs, with one exception (strychnia), act about 
half less powerfully by the rectum than by the stomach. 

Another mode of utilizing the absorptive power of the 
bowel is by suppositories, or pastille-shaped masses of medi- 
cated oil of theobroma, wax, and lard, which are readily 
introduced within the sphincter ani, and where they readily 
melt at the temperature of the body. 

c. Nutrient enemata are of great service in cases where 
swallowing is prevented by cancer or stricture of the oeso- 
phagus, or where we wish to give the stomach, irritated by 
the presence of chronic ulcer, a thorough rest. The great 
difficulty, of course, is that the rectum, although it absorbs 
readily, has no digestive function, so that we must either 
compose our enema of very simple materials, or else add pep- 
sin and acid, or pancreatic fluid. Meat and pancreas ene- 
mata, formed of one pound of finely minced beef, free from 
fat or cellular tissue, with about three ounces of pancreas, 
kept a patient alive for nine months, and two to six ounces 
of freshly delibrinated ox-blood twice a day are said to have 
produced excellent effects in some cases where nourishment 
could not be taken by the mouth, the combination of a grain 
of chloral preventing premature decomposition. 

3. Drugs are occasionally injected into the bladder, but 
its absorptive power, if it exist at all, is very limited. It is 

3* 



30 INTRODUCTION. 

usually only the mucous membrane which is locally attacked in 
this way by weak acids, alkalies, quinine, opium, and the like. 

4. We now come to the most widely used, convenient, and 
generally available mode of using medicines, by introduction 
into the stomach. Swallowing a dose at stated intervals in- 
volves far less trouble and general annoyance, than the other 
plans we have just passed in review, and, after all, is of 
almost universal application in ordinary cases. Occasion- 
ally, where patients will not or cannot swallow, we require 
to pump food, or drugs, artificially into the stomach, but, as 
a general rule, there is no difficulty on that score. It only 
remains for us now 7 to consider the drawbacks we have to 
surmount. 

First. The patient is made fully aware of the too fre- 
quently nauseous taste of his medicine, and we must endeavor 
to conceal this by flavoring ingredients, by capsules, or other 
means. 

Secondly. Our drugs may spoil the appetite, injure the 
digestion, lower the tone of the system, cause nausea and 
depression, and general discomfort, and this we may partly 
avoid by timing their administration at judicious intervals. 

Thirdly. By coming in contact with various secretions, 
the remedy is much altered before it reaches the blood. The 
salivary, pancreatic, or biliary fluids, on the one hand, and 
the gastric juice on the other, must largely neutralize acid 
and alkaline remedies, whilst some drugs may be rendered 
partly inert by stomach digestion, or, like curare, may be 
eliminated too rapidly by the kidney to exert any poisonous 
influence when taken by the mouth. But we must also re- 
member that these and other actions give us substantial 
therapeutic aid. The bile aids the absorption of our oily 
remedies, the gastric juice aids the solution and absorption 
of quinine and other drugs. Many purgatives only act effect- 
ually after previous solution in the alkali of the bile, etc. 



GENERAL RULES FOR PRESCRIBING. 

Preliminary Considerations It will be well, be- 
fore proceeding further, that 1 should lay down some broad 
rules which may guide us in the construction of prescrip- 
tions; and it seems best to introduce this subject here, in- 
stead of placing it, according to more usual custom, at the 



RULES FOR PRESCRIBING. 31 

end of the book, as it is to be our aim and object to devote 
much care and attention throughout to the best modes of 
ordering drugs. Much professional credit may be derived 
from a good prescription, and as much damage done to the 
practitioner who orders for his patients mixtures which are 
neither agreeable to the eye nor palatable to the taste. It 
is well worthy of the student's attention to consider the most 
pleasant, effectual, and convenient way of ordering the drugs 
which are required by the sick, and at first he will no doubt 
consider this a very difficult task. This will partly depend 
on the fact that he has had the subject of doses and thera- 
peutical actions presented to him in such concentrated form 
that he will find some awkwardness in using practically the 
theoretical knowledge which he has laboriously obtained. 
The time at his teacher's disposal is so short that he has to 
run hurriedly from one drug to another, and bring into im- 
mediate relation remedies which differ so widely in their 
effects as to excite some not unnatural confusion in the 
minds of his hearers. It is therefore not an uncommon 
thing to hear students say that they do not think they will 
ever be able to remember the doses of the principal medi 
cines. Then we must remember that, during attendance on 
out-patient practice, prescribing is either done on very rou- 
tine principles, or considerations of time and convenience 
render it advisable to order most drugs according to regis- 
tered formulas, which are merely referred to on the patient's 
notes by name. Thus, although the student may know that 
dyspepsia may be treated by mist. alk. amara, or debility by 
mist, quinia 3 , he would perhaps experience some difficulty in 
writing a prescription suitable for either case. In the wards, 
of course, he sees much more prescribing, but is perhaps not 
very often called upon to do it himself, so that when he settles 
down on his own account it will be some time before he can 
handle medicines with that ease, confidence, and certainty, 
which can alone conduce to the comfort of his patients and 
his own ultimate success. Now it cannot be out of place to 
urge upon him, here, the great importance of frequently exer- 
cising himself in this art. Let him put problems to himself, 
let him run his eye through his text-books, and endeavor to 
order the several drugs in varied combination ; when he 
meets with the recommendation to treat a certain disease in 
a certain way, let him there and then expand these more or 
less vague directions into the form of a prescription ; and so, 



32 INTRODUCTION. 

at last, due blending of ingredients, with the avoidance of 
incompatibles and the concealment of nauseous properties, 
will come to him with perfect ease and efficacy. 

Another point, frhe mere mention of which may cause a 
smile, is the importance of occasionally inspecting, or even 
tasting, the mixtures we prescribe for our patients. Experi- 
ments of this nature will often do more to teach us the effi- 
cient combination of drugs than the most profound theoretical 
knowledge. It is by the experience gained in his own sur- 
gery that the country doctor is often found to order far more 
agreeable prescriptions than the hospital physician, and to 
steer clear of those hopelessly nasty concoctions which are 
occasionally sent out from the unwilling hands of druggists 
in obedience to the orders of scientific authority. 

1. Combination of Drugs The first thing to be 

considered in writing a prescription is the object for which 
we order this certain combination of drugs, which symptoms 
in our patient's case do we wish to alter or modify, what is 
to be our principal ingredient, and in what quantity. This 
being duly settled in our minds, we reflect whether it is bet- 
ter to give this particular article by itself, or to combine it 
with other substances which may possibly assist or mitigate 
its action, or may at all events conceal its more or less 
nauseous taste. Now it is a very commonly given recom- 
mendation that in our prescriptions we should aim at sim- 
plicity as much as possible, and this certainly holds good 
within certain limits. The old-fashioned custom used to be 
to string together a long list of ill-understood substances, in 
the hope that some one or other of them might hit the right 
nail on the head, and even now traces of this polypharmacy 
linger about medical practice. When, however, we are tol- 
erably certain of the action of our drug, and more especially 
when we are making scientific observations on its mode of 
action, it is often of great importance that we should not 
obscure its effects by the addition of any other active sub- 
stances, but order it either simply in distilled water, or merely 
combined with other ingredients for flavoring purposes. But 
we must remember not to carry this principle too far. No 
fact is more thoroughly proved in therapeutics than the value, 
under certain conditions, of due combination, and the way 
in which one drug may assist the action of another. 

Thus, taking the case of diuretics, we know well that a 
prescription containing three or four members of this group 



RULES FOR PRESCRIBING. 33 

will often act where one produces little or no effect, and that 
mercury is of undoubted service in assisting the influence of 
squill and digitalis over the urinary secretion. Cough med- 
icines are always best given in combination with a variety 
of drugs, and the same holds good of purgatives; for we all 
know how hyoscyamus or belladonna will both aid and hold 
in check the action of colocynth, how a little sulphuric acid 
and iron will promote that of "sulphate of magnesia, how jalap 
aids the peristaltic intestinal contraction to remove the watery 
fluid which cream of tartar drains into the bowels. 

Moreover, we all gladly acknowledge the advantage to 
be derived by the addition of a little iron to the digitalis 
which we give as a cardiac tonic, and to the ergot which is 
to stimulate the uterine functions, knowing, as we do, the 
important role which an improved blood supply necessarily 
plays under these circumstances. Narcotics also often gain 
in potency by combination, for do we not know that bromide 
of potassium and chloral together will occasionally cause 
sleep where either separately would have failed ? More- 
over, the use of compound anaesthetic vapors has been much 
popularized of late for this reason. Aromatics are often of 
great service in counteracting the griping tendencies of cer- 
tain active purgatives, and the success which has been 
claimed in some special conditions for Warburg's tincture 
over quinine, is held to be due to the peculiar way in which 
the action of the active ingredient is reinforced by the some- 
what complicated farrago of substances by which it is sur- 
rounded. 

Arsenic is believed by some to prevent the unsightly acne 
produced by bromide of potassium ; and the best mode of 
obviating the discomfort of cinchonism consists in adding a 
little hydrobromic acid to our quinine. [The combination 
of a small amount of opium or morphia with quinia has been 
also found to prevent the occurrence of the disagreeable 
nervous symptoms that sometimes occur, and at the same 
time it increases the antiperiodic power of the drug, so that 
smaller doses may produce equal therapeutic effect.] 

Several alkaline medicines, given together, seem to act 
better in rheumatic fever than the simple administration of 
one member of the group. Tonics, such as quinine and iron, 
are blended with advantage. Then again, we add one drug 
to another for the purpose of counteracting some unpleasant 



34 INTRODUCTION. 

physiological effect; thus spiritus ammonia? aromaticus miti- 
gates the unpleasant symptom of iodism, and atropia lessens 
the chances of discomfort which attend the subcutaneous in- 
jection of morphia. Instances like this might be multiplied 
almost ad infinitum; but we shall develop the subject further 
as we go on, and refer frequently to the laws which should 
guide us in considering whether the various drugs are best 
ordered singly or in combination. 

2. Form of Administration We must take into 

consideration whether we ought to administer our drug in a 
concentrated or diluted form, and here again we shall find 
it necessary to act very differently under different circum- 
stances. As a general rule, we may lay down that the 
metals are best given either in pill or in a small quantity of 
fluid, and this remark applies more especially to those which 
have very active physiological properties. Thus we gene- 
rally give arsenic and perchloride of mercury [corrosive sub- 
limate] in a state of only moderate dilution. Salts, on the 
other hand, and more especially the purgative salts, act best 
when taken in large quantities of fluid, and we shall find in 
practice that iodide of potassium is decidedly more effica- 
cious when freely diluted, that sulphate of magnesia follows 
the same rule, and that in the case of diuretics also we may 
aid their action by combining the directly flooding or me- 
chanically sluicing effect on the kidney of large quantities of 
watery fluid. 

3. Proper Time for Exhibition The period of 

administration is also well deserving of careful study, and 
we may indicate one or two useful rules with regard to the 
action of alkalies and acids. As acids check acid secretions, 
and alkalies have a similar influence over those with alkaline 
reaction and vice versa, we can readily understand the effect 
which they may exercise over digestion. Thus an acid given 
directly before a meal must interfere with the due assimila- 
tion of the nitrogenous articles of diet by checking the sup- 
plies of gastric juice, whereas an alkali given at the same 
time must theoretically produce the best results by stimu- 
lating that secretion. If, on the other hand, we give an 
alkaline medicine after food, we do harm by directly neu- 
tralizing the acid on which some part at least of the active 
principle of the gastric juice depends. 1 

[' An important lesson for the student to learn at the outset is, 
not to place too great reliance upon his own a priori reasoning con- 



RULES FOR PRESCRIBING. 35 

Drugs which have a distinctly lowering or irritating effect 
on the system are best given with or after meals, so as to 
prevent these results as far as possible ; thus we always give 
arsenic or corrosive sublimate or strychnine at these times, 
and find that they are well borne by persons who could not 
take them on an empty stomach. For a different reason, 
again, we generally find it convenient to prescribe cod-liver 
oil after food, not only because it is less likely to cause sick- 
ness when given at that time, but because oily matters being 
absorbed by the lac teals are most readily taken up when 
these structures are in full working order. 

Again, when we wish to imitate or excite a normal physi- 
ological action, we must time our drug accordingly. Opium, 
or any other narcotic, is much more likely to produce sleep 
when taken at night than at other times, and a mild purga- 
tive in the morning will often stimulate the peristaltic move- 
ment of the intestines to evacuate the bowels at the time 
when they are accustomed to act. Again, when we wish to 
re-excite a suspended menstrual flow, we will find our best 
chances of success in directing our remedies more especially 
about the time at which the monthly period ought naturally 
to appear. 

The efficacy of purgatives is also markedly aided by a due 
consideration of the periods at which they ought to be given. 
A resinoid cathartic principle contained in pill is usually of 
slow and deliberate action, and may be given indifferently 
with meals — as in the case of dinner-pills — or on an empty 
stomach before bed-time ; but saline purgatives generally act 
best when given fasting, as the veins of the intestinal tract 
are then less full and more predisposed to rapid absorption. 
As an illustration of this we need only refer to the much 
more potent effect of an ordinary seidlitz powder given before 
than after breakfast. 

Anthelmintics, again, are always best given after as long 
a fast as possible, so that the parasites which they attack 
may not be shielded by food or mucus, and we find in prac- 

cerning the therapeutical effects of remedies. Drugs in many in- 
stances have more than one action upon the economy ; for instance, 
the antiseptic influence of hydrochloric acid may be more efficient 
in gastric disorders than its simple acid reaction ; or the astringent 
effect of aromatic sulphuric acid may be especially serviceable. This 
therapeutic feature is entirely distinct from the varying effect pro- 
duced by altering the size of the dose, which is considered further 
on.] 



36 INTRODUCTION. 

tice that early morning is the most convenient period for 
their administration. 

4. Dosage. — The relative efficiency of large and small 
doses is the next point which has to be taken into consider- 
ation ; and here we are at once confronted by some of the 
most delicate and difficult questions in therapeutics — delicate 
because they border closely on the dangerous ground of 
homoeopathy, difficult on account of their often unsettled 
nature. We cannot pretend to give any exhaustive discus- 
sion to this branch of our subject, because the materials for 
it are not forthcoming, but we can all contribute somewhat 
to its solution by experimental trials of various drugs given 
in these different ways. This much, however, we do know, 
that in many cases we get far more satisfactory results in 
special emergencies, or temporary conditions, by giving one 
tolerably large dose at one time ; and especially is this the 
case with narcotics, small quantities of which only excite 
and annoy, whilst a full dose satisfactorily brings about the 
desired result of sleep. Purgatives and emetics, again, are 
also best given in one considerable dose ; tonics, astringents, 
and diuretics require to be steadily repeated at certain short 
and regular intervals in order to have a sustained and con- 
tinued effect. But the true point at which we wish to arrive 
is this : Can we best obtain rapidly and efficiently the con- 
stitutional action of a drug such as belladonna, or aconite, 
by administering in average quantities two or three times a 
day, or by ordering it to be taken in very small doses often 
repeated? Now supposing we are called upon to treat a 
case of acute tonsillitis or catarrhal febrile disturbance, which 
we wish to remove as rapidly as possible, and we elect 
aconite as the special remedy to be used, the most reliable 
method for its administration is in drop or even half-drop 
doses every hour, half hour, or even ten minutes. General 
experience has pretty well confirmed this teaching, and has 
extended it to other medicines, such as prussic acid, which 
will thus more effectually control urgent sickness than when 
given at longer intervals in the more canonical way ; to tar- 
tar emetic, which in very small and often -repeated quantities, 
exercises a remarkable effect over infantile bronchitis ; to 
ipecacuanha, which in minim doses will frequently check 
obstinate vomiting ; to calomel and gray powder, which in 
minute doses, every half hour, will often stop irritability of 
the stomach when nothing else will succeed. Instances of 



RULES FOR PRESCRIBING. 37 

this sort will be multiplied as our consideration of the indi- 
vidual articles of the Pharmacopoeia goes on, the principle 
being steadily kept in mind that we may often bring the 
system much more efficiently under the special influence of a 
drug, by ordering it in small quantity often repeated, than 
by giving full doses two or three times a day ; and this neces- 
sarily applies with special force to those drugs which are 
rapidly thrown out of the system, and whose action upon the 
structure or function they are particulary supposed to effect, 
is thus kept up and, so to speak, perpetuated, by very fre- 
quent administration. 

On the other hand, we must not forget that certain medi- 
cines must be given in very large quantities before their 
physiological properties are obtained. Thus it would be 
useless to expect succus conii to tranquillize irregular mus- 
cular movement in less doses than f^j [Ph. B. ; the succus 
conii, U. S. P., cannot be safely given in such large amounts, 
as its strength is variable]. Frequently we are required to 
give even more than this : belladanna is of no use in noc- 
turnal incontinence of urine unless boldly pushed up to f 5j or 
f 5jss of the tincture. [In this connection it should be borne 
in mind that the British tincture of belladonna is only one- 
third the strength of that of the U. S. Pharmacopoeia.] Ar- 
senic acts best in chorea when prescribed with no timid hand. 

Another point of interest in connection with this inquiry 
is, that drugs often display different and even opposing 
actions, accordingly as they are given in large or small doses. 
Thus we have seen that drop doses of vin. ipecac, will often 
check vomiting, whereas it is well known that a teaspoonful, 
or even less, will almost immediately evacuate the stomach ; 
sulphate of zinc, in twenty or thirty grain doses, is prized as 
our best emetic, whilst it is equally established that from 
one to ten grains is a valuable nervine tonic, much used by 
some physicians in the treatment of chorea. [Quinia in 
doses of from two to five grains in a tonic ; from six to ten 
grains, a stimulant ; and in large doses is an anti-periodic 
and febrifuge.] Small doses of opium excite, whilst large 
soothe into sleep ; half-ounce doses of infusion of digitalis 
may be more safely given than those of f 3J more frequently 
repeated ; the neutral salts of potash and soda are, as a rule, 
purgative in large, diuretic in small, doses ; and the other 
instances of this principle — which will afterwards be given 
— must be borne in the mind of the prescriber before he can 
4 



38 INTRODUCTION. 

pretend to make most efficient use of the weapons at his 
disposal. 

5. The Interval between Doses The next head- 
ing to which reference is usually made is regarding how 
often we ought to repeat our dose of medicine ; but this is so 
far involved in what has gone before, that very little remains 
to be said. The ordinary rule is to order our mixture to be 
taken three times a day, or every four hours, unless special 
circumstances, such as we have already indicated, render it 
advisable to repeat more frequently. Although many sick 
persons look forward to the time of taking their physic, and 
feel moral as well as physical support from the mere act of 
attending to their doctor's orders, the greater proportion are 
not so favorably impressed, and would willingly be relieved 
from the necessity of swallowing the often nauseous com- 
pounds they receive. Homazopathists, no doubt, derive 
much of their success from the tasteless nature of their medi- 
cines, and we have not yet devoted sufficient attention to 
the elegances and refinements of pharmacy. It is well, 
therefore, to direct our tonics and astringents, and drugs 
whose action is to be spread over some considerable time, to 
be taken three times a day, always bearing in mind those 
important exceptions which recent investigation has done 
such good service in impressing upon our attention. 

6. Individual Peculiarities ; Idiosyncrasy ; 
Habit. — When the student has been fairly emancipated 
from the leading-strings of his teachers, and enters practice 
on his own account, he will often be disappointed at the way 
in which drugs play their allotted parts. The necessarily 
cut-and-dried and dogmatic descriptions of the text-books 
have led him to believe that such and such a medicine will 
always act in a particular way, and he accordingly prescribes 
it with full confidence in a given case. But not only may 
the proper effects fail of development, but very un pleasant 
and almost unlooked-for symptoms may follow its use, which 
will be productive of much discomfort and uncertainty, and 
may even tend to shake his professional credit. The in- 
fluence of that strange individual peculiarity, usually termed 
idiosyncrasy, and of which no reasonable explanation has 
ever been given, must be very carefully taken into account 
in prescribing, and we shall refer to it on all suitable occa- 
sions. Sometimes it renders our patient unduly suscej)tible 
to the action of drugs, and thus we may find one person 



RULES FOR PRESCRIBING. 39 

seriously salivated by one grain of calomel, another who 
dare not touch quinine, a third who is furiously excited by 
opium, whilst a fourth may be poisoned by a single grain of 
morphia. Phosphorus and bromide of potassium also occa- 
sionally cause their peculiar effects in very small doses. A 
good precaution, therefore, is, before prescribing any of these 
drugs, to ascertain from the patient whether he has ever 
taken any of them before, and whether uncomfortable effects 
could be in any way attributable to their use. But, on the 
other hand, our patient's constitution may be such that very 
large quantities of drugs will alone succeed in acting; and 
remarkable stories are told by Christison and others of the 
immense quantities of opium which persons quite unaccus- 
tomed to its use have been occasionally able to take with 
impunity. Purgatives act very differently on different peo- 
ple ; and some require immense quantities of anaesthetic 
vapor before full insensibility is obtained. Although, as I 
have just said, we may often anticipate uncomfortable effects 
by due preliminary inquiry, it too often happens that they 
come on suddenly, and quite unexpectedly. Idiosyncrasy is 
so wide-spread and deep-rooted in the human constitution, in 
almost every function and action, that we can hardly hope 
ever to obtain the key to its mysteries. Why, may we ask, 
do particular articles of diet disagree with special persons ? 
Why does one person, on exposure to cold, take a simple 
catarrh, whilst a second becomes a prey to rheumatic fever, 
and a third escapes unharmed ? Why do we all differ from 
one another in some minor degree in almost everything that 
we do ? Until we can clear up these problems, it is vain for 
us to attempt to explain why we require to adapt our doses 
so carefully to individual constitution and peculiarity ; and 
the reason why the student is at first perplexed by all this is 
that we meet with these differences much more frequently in 
the upper ranks of society. The hospital or dispensary pa- 
tient swallows any dose, however nauseous, with much satis- 
faction, and is much less often affected by those troubles ot 
irregular physiological action which so frequently harass the 
family medical attendant in more aristocratic circles. 

The power therefore, and a power unfortunately too often 
uncommunicable to others, of appreciating the peculiarities 
of different persons in respect of their " behavior" towards 
drugs, is just one of those " knacks" which go far to make 
up success in practice. We ourselves often wonder, or share 



40 INTRODUCTION. 

the surprise of others, why certain doctors, whose scientific 
attainments may be none of the highest, attract and retain 
in a remarkable way the confidence of their patients ; and 
we may be sure that something beyond mere luck, or manner, 
or accident, is the true secret of their superiority. Tact in 
the use of remedies is no doubt in some degree the lever 
which has raised them to their positions, and more especially 
the power which well-remembered experience has conferred 
upon them of knowing intuitively, as we sometimes call it, 
what drugs will best agree with the individual sufferer. We 
yet know nothing of idiosyncrasy beyond the uncomfortable 
fact of its frequent and unsuspected existence, and, in pro- 
portion to our ignorance, all the more keen and persevering 
should be our search after those laws which must inevitably 
regulate its action. This it is which makes, and in the pre- 
sent state of our knoAvledge always must make, the deduc- 
tion from experiment on animals so often fallacious when 
applied to the human subject. I am far from wishing to 
undervalue the benefits conferred on our science by experi- 
ment, but we must remember that brutes have their idiosyn- 
crasies as well as ourselves, and, until both are thoroughly 
understood, therapeutics will lack much of the precision 
which it must eventually attain. And for the further 
elucidation of our own eccentricities in this way we must 
mainly trust to the labors of family practitioners, who will, 
we hope, be induced to publish the names from their great 
field of observation far more copiously than heretofore. 

The influence of habit on therapeutics is also worthy of 
every consideration, for we shall find in practice that medi- 
cines often lose their effect when continued for any length- 
ened period. More especially is this the case with opiates 
and narcotics generally, the dose of which requires to be 
gradually increased from time to time. Arsenic has the 
same peculiarity, as is shown in the case of the arsenic- 
eaters of Styria, who, by long continuance in the use of that 
substance, are at last able to consume quantities which would 
inevitably prove fatal to a novice. And this leads to the 
question of toleration, an old-fashioned term dating from the 
days of heavy dosing with irritating metallic substances, but 
having sufficient bearing on modern practice to justify its 
consideration here. We have said that the term toleration 
savors somewhat of antiquity, because the great illustration 
of this principle used to be afforded by tartar emetic, which 



RULES FOR PRESCRIBING. 41 

was then much more freely used in acute inflammations 
than now ; and when 1 say antiquity I do not refer to any- 
thing more remote than perhaps half a century ago. Then 
the contra-stimulant treatment of pneumonia was in full 
swing, and the curious fact became gradually known that, 
although the first doses of tartar emetic often caused much 
nausea and depression, subsequently larger quantities were 
well borne ; and this was explained by what was called 
toleration of the drug being established in the system. It 
will be seen, when we come to consider in detail the actions 
and uses of tartar emetic, that a very sufficient and scientific 
explanation can be given of this somewhat mysterious effect. 
In these days, inflammatory action is treated on somewhat 
different principles, and antimony is comparatively little 
used ; but the principle of toleration can be recognized in 
the use of other drugs. Thus, in dysentery, quantities of 
ipecacuanha are given which would infallibly produce vio- 
lent vomiting in a healthy subject ; arsenic is better borne 
in skin disease than in a state of health ; choreic patients 
are able to swallow almost emetic doses of zinc sulphate 
without the action of vomiting being induced. Digitalis is 
well known to be given freely in delirium tremens, and 
there is little doubt that the experiment of prescribing half 
an ounce of the tincture to a person in ordinary health 
would be productive of serious if not fatal consequences. 
Further instances of toleration might readily be adduced, 
but it will be much more to the advantage of the student to 
recommend him to pick out other examples for himself than 
to provide him with a cut-and-dried list of all that is known 
on the subject. 

1. Constitutional, or Toxic, Effect from Small 

Doses We next come to what is commonly known as 

accumulation, the theory of which is that certain drugs rest 
or become stored up in the system until they reach a dan- 
gerous quantity, when inconvenient or poisonous symptoms 
may result. Thus we know that after a certain continuance 
in the use of digitalis, faintness and depression have often 
been observed, that strychnia may cause uncomfortable 
twi tchings after it has been taken for some time, that bro- 
mide of potassium only begins to cause annoyance when the 
system seems to have become saturated with the salt. Does 
this really mean that these substances have reached the 
point beyond which their poisonous action is neutralized, so 

4* 



42 INTRODUCTION. 

to speak, by the symptoms which their therapeutical powers 
attack, or is the defect in the organs of elimination which 
fail to expel them efficiently from the system ? It is proba- 
ble that both these and the numerous other examples which 
our subsequent pages will contain depend on both these 
causes in some degree, in addition to another, and that is 
that the organ or tissue towards which the physiological 
action of the drug is directed is, after long-continued stimu- 
lation by repeated small doses, worked up into a certain con- 
dition of special excitement or depression, and discharges 
accordingly. Thus we find the twitchings from strychnia, 
the cardiac depression of digitalis, the nervous weakness 
and ataxy from bromide of potassium, the paralysis resulting 
from alcohol. The metals, as mercury, arsenic, etc., on the 
other hand, no doubt act by being stored up within the tis- 
sues, being brought into excessive action by some defect of 
elimination. 

And the practical outcome is, that in prescribing many of 
these drugs, and more especially digitalis, strychnia, and 
bromide of potassium, it is well to have an occasional break, 
to omit our prescription for a day or two, so as to give the 
parts a rest, and enable the remedy to act afterwards with 
better effect perhaps in even diminished dose. It may happen 
that some of these uncomfortable effects are caused by defects 
in the organs of elimination, and it is therefore very impor- 
tant, when prescribing certain drugs, and more especially 
salicylic acid, to satisfy ourselves, by careful examination of 
the urine, that the kidneys are in thoroughly good working 
order. Recent experiment seems to show that rapidity of 
elimination is encouraged by the high temperature of the 
solution in which the drug is dissolved. 

8. Chemical and Physiolgoical Incompatibil- 
ities — And now we come to the doctrine of incompatibility, 
which is of all-essential importance in therapeutics, consisting 
as it does of the principles which we require to know in 
order to avoid that amount of clashing of the different ingre- 
dients of our prescription which may either alter or destroy 
their action. Now incompatibility may be of different sorts, 
and is generally divided into chemical and physiological. 
Of these we will first consider chemical incompatibility. 

This consists in the chemical action of one drug on an- 
other, which may result in the formation of a new compound 
when they are mixed. Thus the addition of iron to decoc- 



RULES FOR PRESCRIBING. 43 

tion of cinchona will produce an unsightly, black mixture ; 
strychnia and perchloride of mercury will not go with gela- 
tine; sulphuric acid and lead form an insoluble sulphate. A 
good deal of this incompatibility, however, is inconvenient, 
principally, because the resulting solution is often thick, tur- 
bid, and unsightly, and therefore repugnant to the patient. 
Many most incompatible, mixtures are therapeutically effi- 
cient, and some are even prescribed deliberately. Quite 
otherwise is it, however, with the second group, or the physi- 
ological incompatibles, the rationale of which is that the 
action of one drug is so far antagonistic to that of another 
that the mixture of the two is necessarily inert. Thus the 
combination of belladonna and opium is in some degree op- 
posed, so is atropia and prussic acid, aconite and digitalis, 
strychnia and Calabar bean, and, most markedly of all, caus- 
tic alkalies with belladonna, hyoscyamus, stramonium, or 
tobacco, all of whose active principles are thus absolutely 
destroyed. 

But, as already hinted, we often prescribe an incompatible 
mixture for the purpose of actually deriving therapeutic 
advantage from the resulting compound. Thus what is a 
more generally used and, I may confidently say, more useful 
prescription than bichloride of mercury and iodide of potas- 
sium, making an iodide of mercury, which is much more 
efficacious than that salt itself as prepared by more elaborate 
chemical agenc} r F 1 Again, the far-famed mist, ferri co. de- 
rives much of its charm from the freshly prepared carbonate 
of iron which results from the due combination of ferric sul- 
phate and potassium carbonate. Black wash is another 
example; and although corrosive sublimate and decoction of 
bark are undoubtedly incompatible, no better means is known 
of counteracting the depressing effects of this preparation of 
mercury than by this form of administration. 

[Some of the principles of incompatibility, as applied to 
the writing of perscriptions, may be conveniently formulated 
as follows : — 

[' It is true that these salts in solution are chemically incompat- 
ible, as a reaction takes place, and a precipitate is formed. This 
precipitate, however, is soluble in an excess of potassium iodide, 
forming an uncertain compound, which may be looked upon as a 
hydra rgyro-potassic iodide, dissolved in a solution of potassium 
chloride, with other compounds not positively determined.] 



44 INTRODUCTION. 

General Principles of the Incompatibility of Drugs 1. 

As a rule a drug is incompatible with its antidotes and its 
chemical tests, especially if the latter depend upon the form- 
ing of an insoluble precipitate ; thus metallic salts or albumen 
should not be prescribed with substances containing tannin, 
nor chlorides with nitrate of silver. Therefore, in combining 
soluble salts witli each other, or with infusions, be careful to 
see that an insoluble precipitate is not unintentionally formed. 

2. The alkaloids are precipitated by tannic acid and caustic 
alkalies, and may be destroyed by chlorinous compounds. 

3. The alkalies, as a rule, precipitate metallic salts. 

4. Mineral acids decompose salts of vegetable acids, and 
other salts where they have a superior affinity. They form 
ethers with alcoholic preparations. 

5. The glucosides, such as salicin, santonin, and colocynth, 
are decomposed by free acids, or emulsin. 

6. Tinctures in general deposit resin on adding water, 
which also precipitates iodine from its alcoholic solution. 
Infusions containing tannic acid are incompatible with 
metallic salts generally. 

Special Incompatibles In accordance with the first rule 

given above, the table of antidotes placed at the end of the 
book will for the most part suggest the individual incom- 
patibilities. 

The following should as the rule be exhibited alone, or sim- 
ply dissolved in distilled water: corrosive sublimate, tannic 
acid, strychnia, preparations of lead and of iodine, and nitrate 
of silver. With glucosides, or creasote, the latter forms an 
explosive compound, and it should never be prescribed in 
pill with vegetable extracts. 

A mixture of chromic acid and alcohol is explosive, and 
so is chlorate of potassa, when powdered with sulphur or 
tannic acid. 

Aromatic waters sometimes precipitate metallic salts, on 
account of containing a small amount of carbonate of mag- 
nesia. 

Syrup of squill and of garlic contain free acetic acid, and 
are incompatible with carbonates. 

Tincture of chloride of iron precipitates quinia from the 
solution of quinia sulphate, but to some extent redissolves it 
when in large excess. 

Solution of acacia gelatinizes with tincture of the chloride 



RULES FOR PRESCRIBING. 45 

of iron and with borax. It is precipitated by solution of sub- 
acetate of lead, and by alcohol.] 

9. Prescribing for Children. — A few words may 
now be said on the art of prescribing for children, a subject 
which is only incidentally touched upon in our ordinary 
books, and is then treated in a somewhat misleading manner. 
Elaborate tables have, however, been drawn up for the regu- 
lation of doses according to age, and in all of these it is 
assumed that young children necessarily require much 
smaller doses of most drugs than adults ; and this is true in 
so far that it is seldom advisable to deal out our mixtures to 
them in the time r honored tablespoonful or two tablespoon- 
fuls of their elders. But the important fact which these sys- 
tems invariably ignore is this, that children can often take, 
not only with impunity, but even with decided benefit, quan- 
tities of active remedies which will correspond to the full adult 
dose. And the reason of this may be looked for in the much 
greater destruction and construction of tissue in early life, 
whereby the organs of elimination are in unusual activity, 
and hence disposed to excrete medicinal substances with 
special promptitude. Whether we accept this explanation 
or not, however, I may warn the young practitioner that an 
adherence to the rules usually laid down for children's pre- 
scriptions will cause him serious disappointment, and that he 
will be surprised at the beneficial results which will often 
follow the adoption of a bolder course. 

To furnish a few examples of this proposition, I will begin 
with belladonna, which may be used very freely in child- 
hood, and the dose of which I have pushed, in a child of ten 
years of age suffering from incontinence of urine, to f3ij 1 
with good effect, and the development of only very mild 
forms of physiological disturbance. I commonly begin with 
n^xx 1 in a child of two or three, and have prescribed tt^x 1 
in an infant of six months with remarkable benefit ; and the 
result of my experience undoubtedly is, that children bear 
belladonna actually better than grown-up persons, and that in 
them really poisonous symptoms rarely if ever occur. I may 
add that this strange insusceptibility of children to bella- 
donna was first pointed out by the late Dr. Fuller, and has 
since been abundantly confirmed by Dickinson, Ringer, 
Kelly, and others. 

[' British Pharmacopoeia.] 



46 INTRODUCTION. 

Arsenic may also be freely given to children, and, at the 
age of five or six, I should have no hesitation in beginning 
with ttlv [of Fowler's solution] and pushing even up to tti^x 
if necessary. Strychnia is also well borne. Tinct. ferri 
may be taken in large quantities, and I have seen excellent 
results follow the administration of i 5j ter die, in a little girl 
of six years. 

Children will often require large purgative doses, more 
especially of pulv. jalap, co., and of ipecacuanha as an 
emetic. I have often ordered quantities which have start- 
led the dispenser, and induced him to come for explanation 
under the idea that I had made a mistake. Bromide of 
potassium may also be freely given, and other instances will 
be noted as we go on, remembering always the sound old 
advice to be very careful with opium at an early period of 
life. Every practitioner has no doubt seen cases in which 
ill results have unexpectedly followed laudanum prescribed 
before the age of one year, and I cannot do more than reite- 
rate the warnings on this subject which every manual of 
materia medica most properly contains. The explanation of 
this possibly enough may be, that the open fontanelles of 
early childhood permit a much more sudden and effective 
increase in the quantity of blood contained within the skull 
than in adult life, and some confirmation of such an opinion 
may be found in the fact that very young infants will usually 
bear large doses of those narcotics which act by causing an- 
aemia of the brain, and notably of chloral hydrate, which I 
have prescribed with benefit in five-grain doses thrice a day 
to a little child only twelve months old. 

It is always well to make our dose as small as possible, 
one or two teaspoonfuls being usually sufficient, and great 
pains must be taken, by means of well-adjusted flavoring in- 
gredients, to disguise the too often nauseous taste of our 
drugs. Various syrups and aromatic waters here stand us in 
good stead, and it is well if possible, when dealing with very 
young infants, so to reduce the bulk of the medicine as to 
enable it to be mixed unobserved with milk, veal-broth, 
beef-tea, or some sort of confection. In this there is nothing 
really antagonistic to the principle which has just been de- 
veloped, as we can readily enough give considerable quanti- 
ties of belladonna, arsenic, etc., in comparatively small quan- 
tities of water, or even in none at all. 

Children are, however, somewhat strangely capricious in 



RULES FOR PRESCRIBING. 47 

their taste; for whilst they object decidedly to bitter or acid 
substances, they will take oils readily, and generally seem to 
derive satisfaction from sucking in cod-liver oil. Nauseous 
powders which would seem inexpressibly revolting to their 
elders, they often take well, and by a little contriving and 
consideration we can generally manage to persuade them to 
consume their dose with philosophic composure, if not with 
actual relish. 

We may now briefly consider two very interesting points. 

First, the effects of drugs administered to a nursing mother 
on the child. Of this, of course, we have ample evidence, 
knowing, as we do, of the elimination of many medicines 
by the milk, such as iodide and bromide of potassium, rhu- 
barb, and lead. We often find that infants are griped and 
made uncomfortable by their mother's medicine, and we 
must remember this in prescribing, even if we are allowed 
to forget it by the patients themselves, who are usually well 
informed on this point. But little advantage has hitherto 
been taken of this way of treating young children, and it 
seems hardly admissible to recommend a larger recourse to 
so roundabout a plan, as some of the substances used in this 
way might check the secretion of the milk by impairing the 
health of the mother, and as there is no real difficulty in 
giving effective doses of therapeutic agents to children even 
at so early an age. 

When we come to number two, however, some interesting 
speculations are encouraged, for we have to consider in how 
far we can modify or affect the condition of the foetus in 
utero by drugs administered to the mother. There is no 
doubt that a strain of syphilitic infection has been arrested 
by mercury given to the mother during pregnancy, and that 
the infant thus vicariously treated was the first out of a long 
series which proved to be free from all specific taint. Iodine 
and salicylic acid have been detected in the urine of the 
fetus whose mother had taken those substances, and Dr. 
McClintock, of Dublin, records six cases in which the regu- 
lar recurrence of abortions was checked by giving iron and 
chlorate of potash 1 to the mother. For a full ventilation of 
this subject, and a large mass of evidence and opinions on 
either side, we may refer the reader to a discussion in the 
New York Obstetrical Society, January, 1877. 

1 Brit. Med. Journal. 



48 INTRODUCTION. 

10. Prescription Writing. — ^Ye next come to the 
construction, or what we may call the anatomy, of the pre- 
scription itself, how it is put together, and how its compo- 
nent parts are arranged ; and we commence with the ' R ' 
with which it begins, and which originally meant an invoca- 
tion to Jupiter. But, conventionally it has been held to 
imply the verb recipe, which governs the quantity in the 
accusative, the name of the medicine being put in the geni- 
tive. Thus, Recipe (take) pulveris (of powder) scammonice 
(of scammony) scrupulum (a scruple), etc. Other direc- 
tions are laid down in books which deal with this question, 
and much valuable information is contained in Pereira's 
* Selects Praescriptis ' and the clear and instructive little 
work of Dr. Griffith, of Dublin ; but it is hardly necessary 
to reproduce these here, as students beginning their medical 
curriculum are presumably sufficiently well grounded in 
classics to enable them to understand the very moderate 
amount of Latin required for their use in prescribing. As a 
rule, most medical men write their directions now-a-days in 
English; and this has not only the advantage of limiting the 
chance of mistake, but it does away with much of that mys- 
tery which beyond anything else has tended to keep back 
the progress of our art. In these enlightened times, when 
even more than a smattering of physic is commonly possessed 
by the laity, we do not find our patients quietly consenting 
to be kept in the dark as to what medicines they are taking. 
Rather we find them showing a keen interest in our pre- 
scriptions, anxious to inquire, and argue, and, if possible, un- 
derstand all about the line of treatment we have determined 
to pursue. The cases are very rare in which it is necessary 
to conceal from them the presence of any particular drug in 
their mixture, and Latin directions are therefore not only 
unnecessaiy, but pedantic in the highest degree. It is still, 
however, the custom at examining boards to ask the candi- 
dates to write and read prescriptions fully constructed 
according to this custom, and in the prescriptions which 
we shall frequently add to our descriptions of the various 
drugs we shall invariably give the directions in Latin of the 
usual form. 

11. Weights and Measures It only remains for 

us, then, to add the signs and symbols in general use, which 
are as follows : — 



RULES FOR PRESCRIBING. 



49 



gr., granum . 
9, scrupulum (scruple) 
3, drachma (drachm) . 
§, uncia (ounce troy) . 
IB. libra (pound) . 

TTL, minimum 

f'3, fluidrachma (fluid 

drachm) 
f§, fluiduncia (fluid 

ounce) 
0, octarius (pint) 

C, congius (gallon) 



3 scruples . 

8 drachms . 

12 ounces troy 



8 fluid drachms 
16 fluid ounces, 
U.S. P. . 
8 pints 



1 grain. 

20 grains. 

60 grains. 

480 grains. 

5760 grains. 

1 minim. 

60 minims. 

4S0 minims. 

7680 minims. 
61440 minims. 



In the British Pharmacopoeia the time-honored drachm 

and scruple weights have been discarded, and all who pre- 
scribe or dispense medicines are recommended to discon- 
tinue their use; but old-fashioned customs are not so readily 
swept away, and we accordingly find these most convenient 
terms flourishing as much as ever. In domestic practice we 
find a much more rough-and-ready mode of prescribing, the 
generally received measurements being as follows: — 

Drop, usually about ^ mil 



Teaspoonful . 

Dessertspoonful -. 

Tablespoonful 

Wineglassful 

Teacupful 

Breakfast-cupful . 

Tumbler 



= gtt., gutta. 

= 1 fluid drachm. 

= 2 fluid drachms. 

= 4 fluid drachms. 

= H to 2 fluid ounces. 

= 5 fluid ounces. 

= 8 fluid ounces. 

= 10 to 12 fluid ounces. 



Of all domestic modes of measurement, however, none can 
equal the drop in fallacy and danger. The size of a drop is 
influenced first by the shape of the bottle, and secondly by 
the quality of the fluid itself, and hardly any two substances 
Avill be found to contain the same number of drops in a given 
quantity. 

Tablespoons, teaspoons, and all domestic measures are 
most absurdly variable in size, and we shall do well steadily 
to discountenance their use in all cases, and to insist that our 
patients shall carefully regulate their dose by means of those 
graduated glasses which are within the reach of all but the 
very poorest. 

12, Observations upon Doses Now, although it 

would manifestly be lulling our readers into a false security, 
were we to attempt to lay down any absolute rules respecting 
5 



50 INTRODUCTION. 

dosage, we may venture to state some broad principles 
which will help the memory. Students often complain of 
the great difficulty they experience in remembering doses, 
and at first sight it would appear a most irksome task for a 
person not in the habit of prescribing to carry in his mind 
the major and minor quantities of drugs which he may safely 
order. But by giving a few rules, and adding exceptions, 
as in the Latin grammar, we hope to show that there is no 
real difficulty here, but that we may safely group substances 
in such a way as to associate their doses with one another 
with tolerable simplicity. But first let me say one word 
about the British Pharmacopoeia. Constructed as it was by 
official authority several years ago, it is naturally looked upon 
as our vade mecum. and every student is supposed to possess 
a copy and to make himself familiar with its contents. Now, 
in the first edition no doses were given, and in the next, al- 
though these were added in deference to a universal request, 
it was expressly stated that they were not to be considered 
authoritative, or specially enforced by the Medical Council. 
But the Pharmacopoeia, being the only official guide, has 
new been forced into a position respecting dosage which it 
did not intend nor desire, and we therefore find that in any 
case of difficulty its authority is invariably appealed to. It 
lies on every druggist's counter, it is the standard in courts 
of justice, and, this being the case, it ought to reflect the 
most advanced researches on its subject. But this is not 
so ; on many points its recommendations are hopelessly at 
variance with modern practice, and we are hence exposed 
to the annoyance and possible discredit of having our pre- 
scription sent back or cut down by druggists who are afraid 
of exceeding the dose sanctioned by authority. Thus the 
maximum dose of succus conii is fixed by the Pharmacopoeia 
at f'5j, of quinine at gr. x, digitalis f5j ; and when we come 
to consider the various substances in succession, we shall 
find many other examples of a discrepancy between my 
teaching and its statements, which this explanation will clear 
up. [These difficulties are happily avoided by the United 
States Pharmacopoeia, the doses of remedies being judiciously 
omitted.] 

13. General Rule for Doses We may now proeeed 

to indicate the natural system of grouping, by which some 
order may be given to the arrangement of the doses of drugs 



GENERAL PLAN OF ARRANGEMENT. 51 

in the already crowded brain of the student or the young 
practitioner. 

Thus let him remember that, as a general rule, tinctures 
may be prescribed in doses of from rt[x to f 5j> infusions 
and decoctions from f^fss to ^ij, powders from two to ten 
grains, pills four to ten grains ; and although there are nu- 
merous and very important exceptions to this, the recollection 
of the principle will spare us from the drudgery of placing 
the exact dose after every preparation whose action we shall 
examine. 

[The following are the important exceptions to this rule, 
the dose of each of which should be learned separately. 



Tinctura aconiti radicis, 
" belladonna?, 
" cannabis, 
" cantharidis, 
" colcliici, 


U. 


S.P. 

it 

a 
a 
a 


Tinctura nucis vomicae, U.S.P. 
" opii, " 
" " acetata, " 
" " deodorata, " 
" scillaB, " 


n 

a 


coni i, 
digitalis, 
ferri chloridi, 




a 


Infusum 


stramonii, " 

veratri viridis, " 
digitalis, " 




hyoscyami, 

iodinii, 

iodinii compositae 


a 
a 
n 


<< 
a 


capsici, " 
tabaci, " ] 



These rules may be borne in mind in a general way, and 
we shall now go on to consider very briefly the plan of 
arrangement to be pursued when we come to consider the 
various medicinal substances seriatim. 



Our object will be in the following pages, in discussing the 
properties of drugs, to balance, as far as possible, their phy- 
siological against their therapeutical action, arranging them 
in corresponding columns in diagrammatic form ; and it will 
greatly assist this arrangement, as well as aid the memory of 
the student, if we adopt the following order in stating what 
we know respecting the properties of each drug. 

Take, first, its local or external action. 

Then its influence on the brain and on the spinal and sym- 
pathetic system of nerves. 

This will lead us up gradually to the effects on the heart 
and bloodvessels, whose functions are presided over and 
ruled by nervous influence. 

The effects of the drug on respiration and temperature will 



52 INTRODUCTION. 

next be considered, and we then proceed to the alterations 
of secretion in the following order, urinary, intestinal, sali- 
vary, cutaneous, etc. 

Then other actions which come under no heading, and 
which may be called specific. 

Finally, we must consider the various modes of elimina- 
tion from the body, the antidotes, contra-indications, and 
best modes of prescribing; winding up, in most cases, with a 
prescription which will, as far as possible, combine efficiency 
and elegance with palatability. 

It will of course often happen that we cannot accurately 
balance the physiological against the therapeutical action of 
a drug, either from want of sufficient knowledge, or from an 
excess of facts of more or less conflicting nature. We must 
remember that our therapeutical evidence is derived from 
clinical observation on man, and that experiment on the 
lower animals has supplied us with most of our knowledge 
respecting the action of medicinal agents on the healthy 
organism. Fallacies may readily creep into both these 
methods of investigation, and it is evident how the clinical 
method may be hampered by our want of full knowledge of 
the natural history of disease. Although late years have 
done a good deal in showing how various acute maladies be- 
have, when uncomplicated in their course by active medi- 
cation, Ave are still much in the dark, and too prone to 
confuse the propter with the post. And the results of the 
very elaborate system of experimentation, which has lately 
been carried on in Germany and elsewhere, cannot be ac- 
cepted as fully conclusive of the physiological action of the 
various drugs on man. One source of fallacy undoubtedly 
lies in the very differing susceptibility of certain members of 
the brute creation to certain drugs. Thus rabbits freely 
digest belladonna as well as opium ; it is difficult to poison 
pigeons with strychnia, or fowls with prussic acid ; and other 
instances of this curious law have been placed on record. 
It is therefore reasonable to suppose that the special struc- 
ture and habits of the lower animals exercise an equally 
modifying influence with regard to the special action of 
medicinal substances on special organs and functions, so that 
w r e must be prepared to receive some facts drawn from this 
source with a certain amount of reserve. In addition to 
this, the shock and general damage inflicted on the victims 
of experiment by the necessary manipulations must fre- 



GENERAL PLAN OF ARRANGEMENT. 53 

quently alter so seriously the conditions of secretion as to 
render any deductions on this score very inconclusive ; 
whilst, finally, it is well known that drugs which appear to 
have no action on a special organ whilst in health may very 
materially modify its condition when congestion or any other 
form of morbid action has set in. In looking over, there- 
fore, the large mass of evidence furnished by the industry of 
able physiologists, we cannot fail to be struck by the dis- 
crepancy which exists occasionally between the results ob- 
tained. Skilled observers experimenting in different ways 
now and then get different results, and in no case has this 
been more distinctly shown than by the way in which the 
labors of the celebrated Edinburgh Committee have been 
practically set aside by later investigators, who have shown 
that mercurials, as well as other drugs, actually do increase 
the biliary secretion. AVe must therefore bear all this in 
mind, and endeavor so to sift all our evidence as to place in 
our tables only that which the opinion of our best authori- 
ties has thoroughly and fully endorsed. 

In making observations on drugs, we must never forget to 
allow for the varying action which they may have on the 
system in health and in disease. A remedy which has no 
special physiological influence on the normal organism, may 
exert a very appreciable effect on morbid conditions, either 
by removing some obstruction to the natural processes of 
nutrition or secretion, or by supplying the want of some 
vitally essential substance. Thus, antipyretics, like alcohol, 
quinine, digitalis, and the like, produce their lowering effect 
on the body heat far more effectually under pyrexial than 
normal conditions. Iron and phosphorus, which increase 
the number of the red corpuscles in anaemia, have no such 
action in healthy blood ; and mercury, which will blanch a 
sound skin, will speedily restore a healthy bloom to the vic- 
tim of syphilis. Other instances will present themselves in 
the following pages, and the principle is one which must 
always steadily be held in view. 



54 INTRODUCTION. 



THE METRIC SYSTEM IN MEDICINE. 1 

In order to translate our prescriptions into the metric sys- 
tem when so desired, it is only necessary to bear in mind 
that the Gramme or unit of weight is equal to nearly 15^ 
grains (troy), and that a gramme of water occupies the space 
of a cubic centimetre. The relation therefore between the 
two systems would be as follows : — 

OLD STYLE. METRIC. 

n^ j or gr. j equals 06 Gm. 

fSJorgj " 4 

*S 01 '§J " 32 

The decimal line instead of points makes errors impossible. 

As .06 Gm. (Drug) is less than a grain, while 4. and 32. 
(Vehicle) are more than the drachm and ounce, there is no 
danger of giving too large doses of strong drugs. 

C. C. (cubic centimetres) used for Gms. (Grammes) 
causes an error of 5 per cent, (excess). 

A teaspoonful is usually 5 Gms.; a tablespoonful 20 Gms. 

1 For a complete exposition of the metric system, see Weights 
and Measures at the end of the book. 



REMARKS 



CERTAIN CLASSES OF REMEDIES. 



ACIDS. 



"We will first take up the consideration of acids, and, before 
enumerating the therapeutic properties of each individual 
member of the group, it will save time and repetition if we 
draw attention to the collective actions and uses of acids in 
general. 

External Action. 



Physiological. 

Acids, being possessed of 
high diffusive power, rapidly 
permeate tissues to which 
they may be applied, coagu- 
lating their albumen, and, if 
concentrated, absorbing their 
watery constituents and caus- 
ing their destruction. 



Therapeutical. 

Acids, if used in concen- 
trated form, therefore, act as 
caustics, eating away and 
destroying animal tissues. 
When more diluted they are 
astringents, hardening lind 
constringing weakened parts 
and checking unhealthy se- 
cretions. 



Internal Action. 



1. On Circulation. — It is 
stated that phosphoric and 
acetic acids diminish the force 
and frequency of the pulse, 
and reduce the number of 
blood corpuscles. 

All the acids, however, 
have the property of increas- 
ing the acids of the blood, 



1. Xo therapeutical use. 
however, has been made of 
this physiological deduction 
from experiment. [Possibly 
this may be explained by 
their interference with the 
digestive functions.] 

The action of acids in 
checking hemorrhage is thus 
explained, as there is no doubt 



56 



ACIDS. 



probably rather by setting 
free another acid than by a 
direct action on that fluid; 
for by the time they enter the 
circulation they are them- 
selves converted in great 
measure into salts by the va- 
rious alkaline secretions with 
which they have come in con- 
tact. 

They may also contract 
the smaller bloodvessels by 
reflex action, or by directly 
astringing them locally. 

2. No special effects on the 
respiration or nervous system 
have been noted, but phos- 
phoric and acetic acids are 
said slightly to lower the tem- 
perature. 

3. Their action on secre- 
tion is interesting, and has 
been specially pointed out by 
Ringer. It appears that an 
arid applied to the orifice of 
a gland secreting an acid fluid 
will check that secretion, and 
thus any member of this 
group taken into the stomach 
before or at the beginning of 
the process of digestion will 
tend to act unfavorably by 
stopping the flow of gastric 
juice. 



that coagulation of fibrin in 
the vessels is prevented, and 
its fluid condition normally 
maintained and encouraged 
by an alkaline condition of 
the blood. 



They are useful in external 
hemorrhage, and to check ex- 
cessive perspiration. 



3. This physiological action 
points to a valuable bearing 
on therapeutics. Some cases 
of dyspepsia depend on a de- 
ficient production of gastric 
juice, enough of this fluid 
not being secreted under the 
stimulus of food to dissolve 
and digest the albuminous 
constituents. This condition 
may be remedied by mechani- 
cally supplying the want by 
a little acid given some time 
after food. But again, still 
more cases of disordered di- 
gestion are caused by an ex- 
cessive formation of gastric 
juice, the surplus supply of 
acid teasing and worrying 
the mucous membrane of the 
stomach, and causing pain, 
sour eructations, and general 
distress. Here our physio- 



ACIDS. 



But if acids arrest secre- 
tions having their own chem- 
ical reaction, they stimulate 
those which are alkaline, 
markedly increasing their 
quantity. 



4. On the Urine Acids 

increase somewhat the acidity 
of the normal urine, but have 
no power of rendering an al- 
kaline urine acid. This pro- 
perty is alone possessed by 
benzoic and citric acids. 



logical law comes into play, 
and we check the over-secre- 
tion by giving the acid im- 
mediately before the meal. 
Or again, discomfort may re- 
sult from irregular or exces- 
sive fermentation of food, 
giving rise to the formation 
of a large quantity of acetic, 
butyric, and lactic acids ; and 
this undue fermentation is 
found to be itself directly con- 
trolled by acids given in this 
case after food. Possibly some 
of their influence in checking 
acid perspiration may be due 
to this law. 

We can thus explain what 
has been called the refriger- 
ant action of acids, or their 
undoubted influence in reliev- 
ing thirst and imparting a 
fictitious sensation of cool- 
ness. By stimulating the se- 
cretion of the salivary glands, 
we moisten the dry, parched 
mouth of our fever patient, 
and quench his thirst perhaps 
better than in any other way. 

It is probable also that 
some at least of the beneficial 
influence exerted by acids on 
chronic biliary derangement 
is due to their directly in- 
creasing the flow of alkaline 
fluid from the liver. 

4. An alkaline state of 
the urine being due either to 
spinal debility or actual dis- 
ease, the action of alkaline 
remedies, some dyspeptic ten- 
dency, or to local bladder 
causes, it must be variously 



58 ANAESTHETICS. 

treated by appropriate reme- 
dies. 
Acids, by their astringent They are, therefore, good 
properties, brace up relaxed tonics, and act well in diar- 
mucous membranes, and rhoea and profuse sweating, 
check unhealthy secretion. 

Disadvantages. 

The prolonged use of acids is apt to exercise a very un- 
favorable influence on digestion, rendering persons pale and 
languid, and causing a good deal of emaciation ; and this 
was no doubt the secret of the action of vinegar in reducing 
corpulence, which used to be so highly prized in the Byronic 
days, and by incautious indulgence in which so many igno- 
rant people have at various times ruined their health. 

Poisonous Effects. 

The symptoms consist of very violent burning pain in the 
stomach and intestines, vomiting, purging, intense prostra- 
tion, and death either by shock or by the results of secondary 
inflammation. On post-mortem examination, intense inflam- 
mation of the stomach and intestines is found, with ulcera- 
tion of the mucous membrane, and even perforation into the 
peritoneal cavity ; and if the case is of a more lingering 
character, fatty degeneration of various internal organs, but 
more especially the kidneys, becomes gradually developed. 



ANAESTHETICS. 

For a full discussion of the physiological and other pro- 
perties of anesthetics the reader is referred to the subjects of 
Ether, Chloroform, and Nitrous Oxide Gas in the succeed- 
ing section. The consideration of their relative value, as 
stated by Dr. Clover, may be here briefly considered under 
the head of 

The Choice of Anaesthetics. 

[For ordinary surgical cases, ether is safer than chloro- 
form. 

Chloroform is most suitable for children and for aged per- 
sons with brittle arteries, also for sustaining the anesthesia 
during protracted operations inside the mouth. In some cases 
of operation on the eye, when it is desirable to diminish the 



ANTHELMINTICS. 59 

hemorrhage, chloroform is better than ether. In midwifery- 
practice the same may be said. 

Laughing-gas is best for ordinary tooth-extraction, for re- 
ducing luxations or moving stiff joints, for opening abscesses 
and fistula?, and other cases where anaesthesia is required only 
for a short time. For those operations which last from five 
to fifteen minutes it is found that laughing-gas, followed by 
a small quantity of ether, and a very limited supply of fresh 
air, is the anaesthetic least often attended by sickness. The 
recovery of sensation is, however, much more rapid than 
when chloroform or ether alone has been used to the same 
effect, and where great pain is expected to result, a hypoder- 
mic injection of morphia is also needed. 

The mixture of nitrite of amyl with chloroform has been 
strongly advocated recently by Dr. Sandford, an American 
physician. I have tried it in a dozen cases, and find that it 
produces insensibility rapidly, and, if the anaesthetic is then 
removed, the recovery is very satisfactory ; but when the in- 
halation is continued for three or four minutes there seems 
to be nearly as much subsequent depression and nausea as if 
pure chloroform were given. The nitrite lias also the effect 
of producing a sense of fulness in the head in the surgeon 
and assistants, which is rather objectionable. — C] 

ANTHELMINTICS. 

The human body being infested with various parasites, 
whose presence is inconvenient and even dangerous, it is 
necessary for us to be provided with means for their safe and 
speedy removal. Some of these unwelcome guests are, un- 
fortunately, out of the range of medicine ; but others are so 
placed that they can readily be destroyed ; and we shall 
arrange them in classes, according to the several drugs which 
act especially upon them. 

1. Tape-worms are, 1. The best remedy for the 

the taenia solium, derivedfrom teniae is now believed to be 

eating measly pork; the taenia male-fern oil given on an 

medio-canellata, from veal or empty stomach ; but if this 

beef; and the taenia lata, from should possibly fail, we may 

salmon. These occupy the have recourse to kousso, tur- 

small intestine, and give rise pentine, pomegranate root 

to various ill-defined but un- [pelletierine], or areca nut. 



60 



ANTHELMINTICS. 



comfortable sensations ; the 
only truly diagnostic symp- 
tom being the actual passing 
of joints by stool. 



2. The round-worm, or 
asearis lumbricoides 3 

inhabits the small intestine, 
and occasions a long array of 
nervous symptoms, more es- 
pecially in children. These 
worms are supposed to be in- 
troduced into the system by 
impure water. 

3. The thread -worm, 
or oxyuris vermieula- 
ris, is found in the caecum or 
colon, and causes much itch- 
ing and irritation. They are 
almost universal among the 
children of the poor, but 
opinions differ as to whether 
they must be regarded as the 
cause or the effect of the pe- 
culiarly cachectic condition 
with which their presence so 
often coincides. 

Other forms of parasitic 
intrusion within the various 
tissues are well known, but 
are generally incurable ; and 
the trichina spiralis and the 
various forms of hydatid dis- 
ease, when placed in inacces- 
sible organs, must usually be 
permitted to run their de- 
structive course unchecked. 



We must remember that, 
although these remedies kill 
the worms, they do not neces- 
sarily expel them from the in- 
testines, and that a purgative 
may be required for this pur- 
pose ; and it is also essential 
to find the head of the tape- 
worm before we can assure 
our patient that he is freed 
from his tormentor. 

2. Santonin acts as a true 
specific in at once destroying 
these troublesome parasites. 
[It is usually combined with 
calomel and soda to prevent 
the peculiar symptoms of 
santonin poisoning.] 



3. It would seem rather a 
roundabout practice to attack 
parasites in the lower gut by 
drugs administered through 
the mouth ; and although pur- 
gatives, such as scammony 
calomel, jalap, etc., are of use 
in these cases, our chief re- 
liance must be placed on ene- 
mata of quassia, tincture of 
iron, lime-water, common 
salt, etc. 

In the general treatment 
of parasites, we must not trust 
entirely, however, to the use 
of anthelmintics, but must 
also exclude all possibility of 
infection by forbidding raw 
or underdone meat, or fish, 
and by insuring general clean- 
liness and an efficient water- 
supply. In addition to this, 



ANTIDOTES. 



Gl 



When hydatids arc placed, 
however, in the liver, they 
are frequently effectually re- 
moved by tapping, whilst 
those in the lungs not uncom- 
monly undergo spontaneous 
cure. 



we must remedy the un- 
healthy condition of mucous 
membrane which favors their 
development, by giving alka- 
line remediesand bitter tonics 
in various forms of combina- 
tion. [Glycerine is efficient 
in trichiniasis.] 

In prescribing our remedies for the expulsion of the tape- 
worm, it is well to insure a thorough evacuation of the intes- 
tines, so that the parasite may not be in any way shielded 
from the action of the drug by food or mucus. After a pre- 
liminary purge, we direct our patient to fast for a few hours, 
and then administer the fern-oil in milk, either at bed-time 
or in early morning. 



Parasiticides. 



The various external para- 
sites which infest the body 
may be divided into : — 

1. Animal, including the 
Guinea-worm, the acarus sca- 
biei of the itch, and the va- 
rious pediculi met with on the 
head, pubis, and other hairy 



2. Vegetable, to which pa- 
rasitic skin-diseases are due. 
Thus we have the micros- 
poron furfur of pityriasis ver- 
sicolor, the Achorion Schon- 
leinii of favus, the Trico- 
phyton tonsurans of tinea 
tonsurans, and the various 
other forms met with in trop- 
ical practice. 



1. The Guinea-worm is re- 
moved by gentle traction ; 
the itch insect destroyed by 
sulphur or staphisagria; and 
the lice killed by mercurial 
applications [or insect pow- 
der]. 

2. The various parasitic 
diseases of the skin are of too 
well-known obstinacy, and 
may be treated in a variety 
of ways. Iodine, acetic acid, 
chrysophanic acid, mercurials, 
sulphurous acid, carbolic acid, 
and a long array of drugs 
have each their enthusiastic 
partisans. 



ANTIDOTES. 



The first thing to be done 
in any case of poisoning is to 
6 



This may be effected in the 
first place by emetics, and 



62 



ANTIDOTES. 



empty the stomach, and to 
eliminate the poisonous sub- 
stance from the tissues. Some 
qualification however must 
be made in the case of such 
rapidly absorbed and active 
poisons as prussic acid, in 
which the stomach-pump 
brings away nothing, and only 
adds to the general shock. 
We must here have recourse 
at once to the other measures 
indicated below. 



The next stage in our pro- 
ceedings must be to obviate 
the tendency to death, ac- 
cording to the various vital 
processes attacked by the 
poison. 



Having got so far, we must 
then proceed to use our anti- 



more especially those of the 
direct class ; but it will often 
happen, particularly in nar- 
cotic poisoning, that emetics 
will not act, and that we are 
forced to have recourse to the 
stomach-pump. Caution in 
the use of this instrument, 
however, is requisite in cases 
of irritant poisoning in which 
the mucous membrane of the 
stomach is softened or par- 
tially destroyed. When eva- 
cuation of the stomach has 
been completed, we may em- 
ploy gentle purgatives and 
diuretics in addition to such 
remedies as iodide of potas- 
sium, which favor the elimi- 
nation of metallic substances. 

Thus, if cardiac syncope 
be the main symptom, we 
must give stimulants ; if the 
respiratory centre seems in 
danger of becoming para- 
lyzed, we must excite respi- 
ratory action by cold affu- 
sion, irritation of the skin, 
and the employment of arti- 
ficial respiration, and give 
atropia, which stimulates the 
origin of the pneumogastric 
nerve in the medulla; if nar- 
cosis prevail, we must endea- 
vor to rouse the brain ; and 
if irritation of any particular 
organ arises, we must soothe 
it by appropriate remedies. 
[The aid of electricity will be 
found to be not only useful, 
but in some cases absolutely 
indispensable.] 

1. Among the first class 
we may rank alkalies in acid 



ANTIPYRETICS AND REFRIGERANTS. 



63 



dotes proper, which may be 
divided into (1) Chemical, 
which directly neutralize the 
action of the poison by de- 
stroying its properties ; and 
(2) Physiological, which have 
distinctly antagonistic prop- 
erties, being, indeed, in many 
cases, absolute counter-poi- 
sons, and the progress of phy- 
siology and therapeutics has 
recently largely added to our 
knowledge of these. 



poisoning, animal charcoal as 
rendering the vegetable alka- 
loids innocuous, and liquor 
potassa? as depriving bella- 
donna and its congeners of 
all physiological power. 

2. The second contains 
all those various substances 
which will be found described 
here and there in these pages 
as directly antagonistic to 
one another, as opium within 
certain limits to belladonna, 
Calabar bean to atropia and 
strychnia, aconite to digita- 
lis ; and this class of antidotes 
has the advantage over the 
more purely local or chemi- 
cal, that they are able to pur- 
sue their foe into the blood, 
and attack it boldly and suc- 
cessfully there. [Antidotes to 
special poisons are considered 
under their appropriate head- 
ings in the succeeding sec- 
tions. At the close of the 
book will be found a con- 
densed " List of Poisons and 
their Antidotes" for conven- 
ient reference and study.] 



ANTIPYRETICS AND REFRIGERANTS. 



Antipyretics. 

Antipyretics are remedies In this country we are not 
which reduce the bodily tern- much in the habit of regard- 
perature, some acting only ing the temperature, per se, 
against the preternatural heat as a special element of dan- 
of febrile conditions, whilst ger, unless it goes beyond a 
others can also cool down the certain height, and we, there- 
natural warmth below the fore, do not, as a rule, treat 



64 



ANTIPYRETICS AND REFRIGERANTS. 



normal standard. We may 
thus divide their action : — 



Class 1. Those which act 
by directly cooling the sur- 
face of the body by local ap- 
plication. 



Class 2. Those which act 
by internal administration, 
either lessening oxidation, or 
exerting some special influ- 
ence on the nervous system. 



Class 3. Those which act 
by dilating the superficial 
vessels and enabling a larger 
sheet of blood to be spread 
over the cutaneous surface, 
and thus brought in contact 
with the cooling; influence of 



this symptom very energeti- 
cally. Foreign experience 
seems to show that, although 
we may reduce the actual heat 
in acute disease, we do not 
necessarily alter the course of 
the attack, and we, therefore, 
usually confine our efforts to 
supporting our patient and 
looking out for complications. 
On the other hand, however, 
when the thermometer regis- 
ters 105°, and still tends up- 
wards, we are bound to inter- 
fere. 

1. This is, undoubtedly, 
our most effectual antipyretic 
means, and may be carried 
out by cold affusion, wet pack, 
or, best o£ all, by the care- 
fully graduated cold bath. 

2. This class consists of 
the antipyretic drugs, prop- 
erly so called, such as qui- 
nine, digitalis, veratria, alco- 
hol, salicylic acid, etc. ; but, 
with the exception of the last- 
named, they are not much 
used for this purpose. It is 
a remarkable fact, that very 
few, if any, of these drugs 
have the power of reducing 
the normal temperature, save 
when given in large and al- 
most poisonous closes {vide 
Alcohol, Quinine, etc.). 

3. Under this heading we 
must include the whole class 
of diaphoretics, as well as 
chloral hydrate, the warm 
and Turkish bath, etc. 



ANTIPYRETICS AND REFRIGERANTS. G5 

the air. The chilling effect 
then produced by the return 
of the circulating fluid to the 
heated centres, although very 
transient, may become con- 
siderable by repetition. 

Class 4. Remedies which 4. A rising temperature 

act by bracing up and being often an indication of 
strengthening the nervous debility, we may then check 
system, and removing some it by tonics, good food, small 
of that enfeebled and semi- doses of alcohol, etc. 
paralyzed condition on which 
febrile temperatures have 
been supposed to depend. 
Those who, like Lieber- 
meister, adopt the antipy- 
retic plan in its entirety, 
combine the various agents. 
Whilst using very frequent 
baths, as often as every two 
hours — in severe cases two 
hundred, even, having been 
given during one illness — he 
orders quinine in large doses. 
holding it first among cooling 
agents ; digitalis where the 
heart is strong, thus revers- 
ing our usual therapeutical 
rules ; and veratria, which 
seems to act by causing a 
kind of collapse. Statistics. 
however, do not show any 
superiority of this over the 
more expectant plan prac- 
tised in England. Prof. 
Gairdner {Glasgow Med. 
Journal, September, 1878) 
well calls the German plan 
a battledore and shuttlecock 
treatment, consisting, as it 
does, " in keeping the pa- 
tient, partly by means of 
cold baths, and partly by 

G* 



66 ANTISEPTICS AND DISINFECTANTS. 

these other remedies, in a 
state of constant oscillation 
between fever and incipient 
collapse." 

Refrigerants. 

Refrigerants, of course, necessarily include all remedies 
which actually lower the bodily temperature, but the con- 
ventionally accepted meaning of the term merely implies 
anything which alleviates thirst. Thus we find that the 
mere sipping of any fluid moistens the dry tongue and les- 
sens the thirst of fever, whilst acids, by stimulating the 
secretion of saliva, may fulfil the same indication in a more 
scientific and effectual way. 

ANTISEPTICS AND DISINFECTANTS. 

Dr. Parkes proposed that the term disinfectant should be 
restricted to those substances which arrest the spread of spe- 
cific disease depending on the entrance into the body of a 
special agent ab externo, and that agents acting in other 
ways should be called air purifiers and sewage deodorants. 
It would seem well, however, to adhere in these pages to 
the nomenclature most commonly in use in our received 
text-books of Materia Medica, and, whilst willingly conced- 
ing the palm of scientific precision to Professor Parkes, I 
shall adopt the following division of the subject into disin- 
fectants and antiseptics. 

Disinfectants are those substances which act by destroy- 
ing offensive animal or vegetable effluences, arresting putre- 
faction, and stopping the spread of infectious and epidemic 
disease by destroying the particles on which the poison of 
these diseases is supposed to depend. How they do this is 
not matter of absolute certainty, but they act in many cases 
by direct chemical agency, by deoxidizing, or by taking up 
hydrogen and water ; and the theory of the modus operandi 
of various substances here enumerated will be considered 
when each of them comes separately under review. Adopt- 
ing, then, in some measure the nomenclature of Parkes, dis- 
infectants may be divided into — 

1. Air purifiers, which we may again subdivide into — 

(1) Solid air purifiers, of wdrich charcoal is the best, also 
dried earth, quick-lime, etc. 



ANTISEPTICS AND DISINFECTANTS. G7 

(2) Liquid air purifiers; Condy's fluid, zinc chloride, 
lead nitrate : and, 

(3) Gaseous air purifiers; such as ozone, chlorine, iodine, 
bromine, nitrous acid, sulphurous acid, and carbolic acid. 

2. We may next include the sewage deodorants, of which 
charcoal, dry earth (as in Moule's patent system), iron per- 
chloride, quick-lime, potassic permanganate, carbolic acid 
(with the various powders, such as M'Dougal's and Calvert's, 
which are prepared from it), are the most prominent. 

3. Finally we have what Dr. Parkes calls disinfectants 
proper, which arrest contagious disease by destroying the 
particles of matter which pass away from the bodies of the 
sick. Of these heat is a valuable member, it being now well 
known that a dry heat, as of an oven at over 212°, will 
completely disinfect clothing. 

Chlorine is effectual, but irritating; nitrous acid vapor 
has been recommended, carbolic acid is of undoubted ser- 
vice, but sulphate of iron seems to be of very doubtful utility. 

Professor Baxter limits the term disinfectants to "agents 
capable of so modifying the contagium of a communicable 
disease, during its transit from a sick to a healthy individual, 
as to deprive it of its specific power of infecting the latter." 

Antiseptics are those substances which arrest the spread 
of disease and decomposition generally, not by chemical 
action, but by a poisonous effect on the septic microzymes 
on which these .processes depend. It is, therefore, clear that 
they dovetail very essentially with the preceding group, more 
especially as it is difficult to draw a hard-and-fast line be- 
tween those disinfectants which act chemically and those 
which arrest putrefaction and infective processes in other 
ways. The term antiseptic, therefore, is superfluous, and 
would probably have dropped altogether out of use had it 
not been for the term antiseptic surgery, which has been so 
extensively employed by Mr. Lister and his school, the theory 
being that putrefaction and pyamiia depend upon the presence 
of innumerable germs from which these substances free the air. 

The principal are carbolic acid, zinc chloride, boracic 
acid, salicylic acid, sulphurous acid, corrosive sublimate, and 
perchloride of iron. 

The term parasiticide has also been employed as indicat- 
ing those substances which specially act as poisons to the 
minute animal or vegetable life, and are used medicinally 
with this view. Thus sulphurous acid and perchloride of 



68 ASTRINGENTS AND CAUSTICS. 

mercury are used with success as local applications in various 
forms of parasitic skin disease, and sulphurous acid is bene- 
ficial in those cases of vomiting which depend on the irri- 
tation of low forms of cryptogamic vegetation imbedded in 
the mucous glands of the stomach. 



[ASTRINGENTS AND CAUSTICS. 

The property of ^stringency, or " puckering," is possessed 
by vegetable substances containing tannic acid and its deri- 
vatives ; and, on the other hand, by many mineral salts. 
Astringents generally possess the power of coagulating albu- 
men, but their therapeutic effect is* rarely required to this 
extent ; in less degree of strength they excite a tendency to 
condensation or contraction of living organisms, partly, but 
not mainly, by local influence upon the unstriped muscular 
fibres. In a higher degree they generally act as irritants, or 
even caustics. When used to check bleeding they are 
termed styptics. Astringents find their greatest field of 
usefulness in a relaxed condition of mucous surfaces with 
excessive follicular secretion. In cases of inflammation their 
tendency to exercise an irritant influence should not be lost 
sight of. 

Extremes of temperature such as are obtained by either 
hot or cold applications will check hemorrhage ; the cold 
acts as an astringent, but the heat more rapidly coagulates 
blood. 

The vegetable astringents are tannic and gallic acids, and 
their allied forms, as kino-tannic and catechu-tannic and 
gallo-tannic. Acetic acid and Aveak solutions of carbolic 
acid also are decidedly astringent. It may be that the effect 
of chrysophanic acid in psoriasis is largely due to an astrin- 
gent effect upon the vascular supply of the diseased skin. 

The principal mineral astringents are sulphuric acid, and 
the soluble sulphates generally, particularly the ferrous and 
cupric sulphate ; but the soluble compounds of zinc, silver, 
lead, copper, cadmium, and aluminum are generally astrin- 
gent. The ferric salts with mineral acids, the ammonio- 
ferric sulphate, the calcic hydrate and carbonate, alum, sub- 
nitrate and subcarbonate of bismuth, and some of the volatile 
oils and resins are also to be included in the categorv. 

Caustics are used to destroy tissues, and belong more par- 



COUNTER-IRRITANTS. 69 

ticularly to surgery. When the application is mitigated or 
used in dilute solutions, the first effect of caustics, as a rule, 
is that of a stimulant and irritant, and they may exert an 
astringent effect. The principal agents used as caustics 
may be classified according to their action as follows : — 

CAUSTICS. 

PENETRATING. CIRCUMSCRIBED. 

Acetic acid. Dried alum. 

Bromine. Dried zinc sulphate. 

Chromic acid. Heat. 

Mercuric nitrate solution. Potassa with lime. 

Potassa. Silver nitrate. 

Sulphuric type-acids. • Zinc chloride.] 



COUNTER-IRRITANTS, 

The theory of the action of epispastics and rubefacients 
has given rise to much interesting physiological speculation, 
but we are not yet able to lay down, with absolute precision, 
the laws on which the beneficial action of these remedial 
agents depends. We know this much, however, that blis- 
ters may occasionally act locally on deeper-seated parts, as 
we are told that redness and inflammation of pleura and 
peritoneum may be produced by the vesicating influence of 
cantharides applied to the cutaneous surface superficial to 
these structures. 

Then, again, vascular connection may explain other phe- 
nomena, and more especially may this be traced in the chest 
between the pericardial vessels and those of the skin imme- 
diately over the heart, and in the lumbar region between the 
superficial vascular supply and that which furnishes to the 
kidneys their due allowance of arterial blood. 

These more direct and obvious explanations of various 
interesting therapeutical phenomena do not, however, lead 
us very far, and we are compelled to fall back upon much 
more abstruse considerations. Into these neither our space 
nor the scope of the present volume will permit us to enter 
very far, and we only very briefly draw a slight outline of 
those branches of the question which seem to have reached 
something of vigorous growth. 

Now for the relief of pain, counter-irritation may act, 1st, 
by removing or modifying the structural condition on which 



70 



DIAPHORETICS, 



the reflected suffering depends, as we often cure a facial 
neuralgia by extracting a carious tooth ; or 2d, the end organs 
of the sensory nerves may be modified in molecular arrange- 
ment ; or 3d, the trunks of the nerves themselves, or the 
nuclei or the nervous centres, may be altered in some unex- 
plained way by the stimulus applied to the seat of pain. 

For other purposes, also, counter-irritation may act by 
altering or re-distributing blood supply, as by actually empty- 
ing the deeper vessels and filling the more superficial arteri- 
oles at their expense ; or special function or nutrition may 
be profoundly affected by influencing the trophic or other 
nerves which more especially preside over these departments 
of the economy. 

The practical applications of counter-irritation in the 
treatment of disease are both numerous and interesting; and 
when considering iodine, mustard, and cantharides, we will 
devote some space to the consideration of the principles 
which should guide us to their successful use. 



DIAPHORETICS. 



This class of remedies has 
the property of increasing 
the secretions of the skin, 
and is usually divided into 
(1) the stimulating and (2) 
the sedative. Under the 
first heading we include 
those drugs which stimulate 
the cutaneous circulation, 
among the principal of which 
are ammonia, alcohol, the 
cold bath, phosphorus, etc. ; 
and, secondly, we speak of 
the sedative class, which act 
by dilating the superficial 
vessels, these being ipecac- 
uanha, tartar emetic, jabo- 
randi, aconite, the warm 
bath, and all the nauseating 
and emetic substances, the 
depressing action of which is 
invariably attended by free 



Diaphoretics are used 
freely in practice at the out- 
set of acute diseases, to relax 
the contracted vessels and 
relieve the hot, dry skin, and 
in pneumonia this line of 
treatment has produced good 
results. The sedative class 
would seem to be best adapt- 
ed for this purpose; but the 
cold bath, which more natu- 
rally belongs to No. 1, has 
been freely used abroad in 
febrile disorders, and part of 
its beneficial effects must no 
doubt be due to its action on 
the skin. 

In eruptive fevers, when 
the eruption is not sufficiently 
developed, we endeavor to 
excite the function of the 
skin, and thus favor the local 



DIURETICS. 71 

perspiration. Then again manifestation of the poison, 
we must refer to what are by warm baths, wet-packing, 
known as adjuvant remedies, and possibly by phosphorus. 
such as warmth to the sur- We also use diaphoretics to 
face, diluent drinks, etc. favor absorption, as in various 

dropsies, and to relieve the 
kidneys, between which and 
the skin so much sympathy 
exists. 

They are also of service 
by assisting to eliminate mor- 
bid products from the blood. 
When the various internal 
organs, whose duty it is to 
get rid of certain effete and 
hurtful matters, are tempo- 
rarily or permanently off 
work, we may hope to sup- 
ply their place in some meas- 
ure by the skin, and in 
Bright's disease we may thus 
relieve the system of some 
urea; in jaundice, of biliary 
products, etc. 

DIURETICS. 

Diuretics stimulate and increase the flow of watery fluid 
through the kidneys in various ways, which we may conve- 
niently classify under the following headings : — 

Class 1. Stimulating diu- 1. These are cantharides, 
retics, which act by directly turpentine, colchicum, etc., 
exciting or irritating the but they are rarely thus used, 
glandular secreting structures as they are liable to produce 
of the kidney. pain, strangury, and even 

hemorrhage. Cantharides 
has, however, been recom- 
mended in some forms of 
chronic albuminuria and in 
pyelitis. 
Class 2. Those drugs which 2. The principal of these 

stimulate the circulation, are digitalis, belladonna, 



72 



DIURETICS. 



causing increased arterial 
tension, and thus greater 
pressure on the walls of the 
Malpighian bodies, by which 
means transudation of watery 
fluid is mechanically favored. 

Class 3. We next come to 
the saline diuretics, which, 
in addition to some slightly 
stimulating influence, have a 
special power of absorbing 
and holding watery fluids, 
which they then carry with 
them in their exit from the 
body. 

Class 4. Mechanical diu- 
retics must next be included 
in the list, and among the 
principal of these we may 
mention water, which acts 
by washing the urinary tu- 
bules clear from epithelium 
or casts, which block them 
under certain conditions, and 
so allowing secretion to be 
re-established. Under this 
heading we may also group 
those remedial means which 
act indirectly by relieving 
the kidneys in various ways. 
Thus, Avhen congestion is 
present, local bleeding, dry 
cupping, warm fomentation, 
etc., may be the best diure- 
tics. When the kidneys are 
pressed upon by ascitic fluid, 
a renewal of their full func- 
tion frequently follows the 
operation of tapping, and in 
many cases we may give 
these organs temporary rest 
by handing some part of 
their duties over to the skin 
or the bowels. 



squill, and ergot ; and they 
are of service in various drop- 
sies, and perhaps most espe- 
cially in those which depend 
on disease of the heart. 

3. In this group we include 
the lithia, potash, and soda 
salts, and most of them pos- 
sess a double action, being 
diuretic in small, and purga- 
tive in large doses. They 
are also used with advantage 
in anasarca and dropsical ac- 
cumulations. 

4. Dr. Dickinson has shown 
how well copious draughts of 
water act in the acute de- 
squamative nephritis of chil- 
dren, on the mere mechanical 
principle of sluicing or wash- 
ing out the obstructed tu- 
bules. The indirect diuretics 
are often of most service in 
renal disease ; but Christison, 
Gairdner, and other experi- 
enced authorities have always 
upheld the benefits to be de- 
rived by the treatment of 
Bright's disease in all its 
stages by the less stimulating 
forms of diuretics. 



EMETICS. 



73 



Diuretics are notoriously uncertain remedies, and many 
of them have not the slightest power of increasing the flow 
of urinary water during health. They also vary much in 
their power of promoting the elimination of urea and other 
products of excretion by the kidneys. They may be given 
either by the mouth or by vapor (in which way oil of juniper 
acts well) ; or, as in the case of digitalis, they may be effi- 
ciently used by cutaneous absorption. In their administra- 
tion we must observe the following rules : Give them freely 
diluted, and, as a rule, combined one with another, as several 
remedies of the class seem to act better than one, as in the 
famous Guy's pill. Keep the patient cool, so as to avoid 
any action on the skin, and endeavor to prevent the bowels 
from coming too freely into play. 

EMETICS. 



The object of an emetic is to stimulate the so-called 
vomiting centre in the medulla oblongata, close to the origin 
of the pneumogastric nerve, and induce it to call forth the 
complicated series of muscular acts which terminates in 



evacaution of the stomach, 
are thus classed, as: — 



Emetics act in two ways, and 



Direct. 

Where the drug irritates 
the filaments of the pneumo- 
gastric nerve distributed to 
the mucous membrane of the 
stomach, and this irritation, 
being transmitted to the cen- 
tre, is reflected in motor im- 
pulses through the pneumo- 
gastric, phrenic, and intercos- 
tal nerves. The direct emetics 
are prompt in their action, 
and cause little nausea and 
depression; and the principal 
members are zinc sulphate, 
copper sulphate, ammonium 
carbonate, mustard, common 
salt, etc. 
7 



Indirect. 

Emetics of this class are 
conveyed directly by the 
medium of the blood to the 
vomiting centre, and act well 
by injection without coming 
into con tact with the stomach. 
They are less prompt and 
more depressing than those 
of the other class. Principal 
members : Ipecacuanha, eme- 
tia, tartarized antimony, apo- 
morphia, veratria, and del- 
phinia. 



74 



EMETICS. 



The reflex chain then being established by which the 
muscular apparatus causes vomiting, we must next consider 
the various steps of the process. 



Physiology of Vomiting. 

1. In the first place the 
cardiac sphincter must be re- 
laxed, or no vomiting can 
take place, and the persistent 
contraction of this structure 
may account for many cases 
of distressing retching 1 . 

2. The actual contraction 
of the walls of the stomach 
itself, must be supplemented 
by that of the abdominal 
parietes. 

3. The diaphragm descends 
and becomes fixed, so that the 
various muscles compressing 
the stomach act between two 
fixed points. 

4. The glottis is closed. 

5. As vomiting cannot be 
effectually accomplished if 
the stomach is quite empty, 
under these circumstances 
the patient generally swal- 
lows a certain quantity of air, 
so as to distend the viscus. 



Therapeutics. 

Emetics are used to empty 
the stomach in cases of poison- 
ing, and here we invariably 
employ the direct class, such 
as the zinc sulphate, mustard, 
salt, etc. 

They are also of service in 
some forms of dyspepsia, and 
to clear the stomach in in- 
toxication, and for the relief 
of the convulsions of infancy, 
which often depend on irri- 
tating articles of diet. 

[Where the direct emetics 
are contra-indicated, we may 
resort to the indirect, which 
act by absorption. Emetia 
and apomorphia will cause 
vomiting if injected hypo- 
derinically.] 



1. Action on the Brain 

and Nervous System 

Emetics may cause some 
congestion of the brain by 
the obstructed venous return 
from the neck during the act 
of vomiting. 

2. Circulation and Respi- 
ration. — They have a seda- 
tive action on the heart. 

As the respiratory is close 



1. We must therefore avoid 
their use in apoplectic cases. 



2. Emetics are of great 
service in clearing the lungs 
in bronchitis, and in getting 
rid of the false membrane 



EMMENAGOGUES AND ECBOLICS. 



75 



to the vomiting centre, the 
breathing generally becomes 
sighing and irregular during 
the act of vomiting ; but in 
addition to this there is an 
increase of secretion from the 
pulmonary mucous mem- 
brane, and the compression 
of the lungs forces retained 
mucus out of the bronchial 
tubes. 

3. Organs of Secretion. — 
By the pressure exerted on 
the intestines, some slight 
purgative action may result, 
and prolonged vomiting al- 
ways leads to the discharge 
of bile from the stomach by 
the mechanical squeezing of 
the liver and gall-bladder. 
Emetics invariably cause free 
perspiration during their ac- 
tion, as well as an increased 
flow of saliva. 



in croup and diphtheria, and 
they may thus be said to act. 
as expectorants. We had 
here best use such emetics as 
ipecacuanha and tartarized 
antimony, which combine an 
expectorant action. 



3. Emetics may therefore 
be said to act as cholagogues, 
and may be of great service 
in stimulating the action of 
the liver, and removing in- 
spissated secretions from the 
gall-bladder. Some authori- 
ties hold that it is good prac- 
tice to give an emetic as 
early as possible at the outset 
of fevers, such as enteric; 
and it has been suggested 
that the fever poison is re- 
tained at this stage in the 
bile, and may be expelled 
along with it from the system. 



EMMENAGOGUES AND ECBOLICS. 

Of these we may consider, first, 



Ecbolics. 



Physiological Action. 

Ecbolics are substances 
which cause such violent 
contraction of the pregnant 
uterus as to effect the expul- 
sion of its contents. It is 
not quite certain, whether 
the principal members of the 
group act specially on the 



Therapeutical Action. 

Ecbolics are used exten- 
sively in obstetric practice 
when it becomes necessary to 
stimulate the flagging powers 
of an exhausted uterus — the 
principal being ergot, digi- 
talis, savin, borax, quinine. 
We are also compelled, under 



76 



EXPECTORANTS, 



muscular structures of the 
organ, or whether a primary 
intervention of nervous in- 
fluence through the spinal 
cord is necessary. 



certain circumstances, to have 
recourse to the induction of 
premature labor, as when 
dangerous sickness goes on 
unchecked, or when weak- 
ened abdominal or thoracic 
viscera are injuriously com- 
pressed by the pregnant ute- 
rus. In such cases, however, 
it is generally found best to 
use mechanical means. 



Emmenagogues. 



May be direct or indirect. 
Physiological Action. 

Direct emmenagogues act 
merely by restoring the nor- 
mal functions of the uterus 
when these are suspended. 



Indirect emmenagogues act 
by removing some constitu- 
tional condition which inter- 
feres with the due perform- 
ance of the uterine functions. 
Thus amenorrhoca very fre- 
quently depends on anamiia, 
or constipation may require 
removal before our more spe- 
cial remedies will act. 



Therapeutical Action. 

Most of the ecbolic drugs 
act as emmenagogues when 
given in small doses to a non- 
pregnant patient, and to the 
list we may add rue and cas- 
tor. Of all these, however, 
ergot is by far the most ef- 
fectual. 

The different preparations 
of iron, in combination with 
aloetic or other purgatives, 
act well, and we may aid our 
chances of success by all hy- 
gienic means, as well as by 
warm hip-baths, leeches, and 
mustard stupes, at the normal 
menstrual periods. 



EXPECTORANTS. 

These are remedies which facilitate in various ways the 
expulsion of secretion from the bronchial tubes. They may 
thus be divided : — 

1. The emetic class, which 1. There can be no doubt 

are the most efficient of all, that, when the lungs are 



EXPECTORANTS. 



77 



removing and softening the 
mucus, causing the transuda- 
tion of watery fluids, and re- 
laxing the muscular walls of 
the bronchial tubes. 



2. Nauseants may also be 
of service as expectorants. 



3. We then have what are 
called the stimulating expec- 
torants, acting either on the 
general vascular system, or 
specially on the nervous and 
muscular structures of the 
lungs. 



4. Those remedies which 
promote secretion from a dry 
and swollen mucous mem- 
brane. 



5. Expectoration is often 
rendered difficult by tena- 
city of the mucus, which is 
coughed up, only after much 
straining and effort, and great 
relief follows e verydrug which 



choked with secretion, a good 
emetic often acts like a charm, 
as in bronchitis, whooping- 
cough, etc. 

We must here use the in- 
direct emetic agents, as apo- 
morphia, ipecacuanha, etc. 

2. These are merely the 
indirect emetic drugs given 
in small doses, as antimony, 
. ipecacuanha, etc. 

8. These are senega, am- 
monia, etc. ; but it is evident 
that any tonic or stimulating 
remedy may frequently act 
indirectly as an expectorant, 
by improving the tone of the 
circulation, and giving the 
patient strength to cough and 
clear his lungs. The stimu- 
lating expectorants are more 
especially used in the later 
stages of pulmonary disease. 

4. In the earlier stages of 
bronchitis much discomfort 
occurs from the dry hard., 
cough and difficulty of breath- 
ing arising from swelling of 
the bronchial mucous lining. 
Great relief is experienced 
when free expectoration is 
established, and this may be 
promoted by inhalation of 
steam, liq. ammonii acet., lo- 
belia, and the class of nause- 
ants generally. 

5. We find that alkalies act 
well here, and, if any gouty 
tendency exists, more espe- 
cially potassium iodide, 



78 NARCOTICS AND ANODYNES. 

can thin or liquefy the secre- 
tion. 

6. Spasmodic contraction 6. Here we may hope to 

of the smaller bronchial tubes obtain relief by the use of 

may interfere with free ex- opium, belladonna, stramoni- 

pectoration. um, tobacco, etc. 



NARCOTICS AND ANODYNES. 

Narcotics, as the name implies, are those remedies which 
cause sleep, and they do so by imitating the normal physio- 
logical arrangement of that condition, and producing an anae- 
mic state of the cerebral hemispheres. Why they act in this 
selective way on the brain is not very clear ; for although 
opium contracts the bloodvessels, thus arresting nearly all 
secretion, chloral has a dilating effect, and pot. bromid. lias 
not been proved to have any special action on the circulation 
at all. Bernard's theory of independent vascular areas acted 
on by special drugs only removes the difficulty further back, 
as, of course, we are totally unable to explain why one drug 
affects one region or function, and a different one another. 
But whatever the explanation may be, we all gratefully ac- 
knowledge the enormous benefits derived from the control 
over the reparative process of sleep these remedies afford us, 
and a reasonable mode of division seems to be into — 1st, 
direct narcotics ; 2d, indirect narcotics. 



1. Direct Narcotics. 

Physiological. Therapeutical. 

These are the following Opium is, beyond doubt, 

drugs, named in their order the most potent and certain, 

of potency, as opium, chloral and, perhaps, least dangerous 

hydrate, potassium bromide, narcotic ; but the digestive 

hyoscyamus, belladonna, hop, disturbance unhappily follow- 

and Indian hemp. The pe- ing its use often interferes 

culiar action of chloral, how- with its continued adminis- 

ever, occasionally causes its tration. It is, no doubt, best 

failure in cases of debility, adapted of all the remedies of 

where it acts by increasing this class for use in fevers and 

the natural tendency of the in all painful conditions, on 

relaxed arteries to dilate, thus account of its anodyne pro- 



NARCOTICS AND ANODYNES. 



79 



flushing the brain with blood 
during recumbency, effectu- 
ally preventing sleep. 



perties. Chloral is more to 
be recommended in simple 
insomnia, in delirium tre- 
mens, and in all cases where 
we wish to keep up a pro- 
longed narcotic effect, as it is 
not requisite, as a general 
rule, to increase the dose. 
Bromide of potassium is well 
adapted to soothe the system, 
when once excited by worry 
or over-work, and the others 
are occasionally useful when 
success has not been attained 
by other means. 



2. Indirect Narcotics. 



Physiological. 

First on this list we must 
place those drugs which sec- 
ondarily affect the brain cir- 
culation by toning up the ar- 
teries, and thus regulating the 
supply of blood. Digitalis is 
here all important ; and iron, 
also, has its place, by improv- 
ing the quality of the blood. 
A little alcohol, given at the 
right time, will often produce 
sleep ; and it is well known 
that the state of exhaustion 
produced by an empty sto- 
mach will often lead to pro- 
longed wakefulness, only to 
be removed by a little food. 



Darkness and quiet, and 
warmth, promote slumber,and 
the opposite condition of cold 
is well known to cause a co- 
matose condition, too often 



Therapeutical. 

Digitalis often acts very 
efficiently, as a narcotic, by 
removing that relaxed condi- 
tion of vessels which substi- 
tutes congestion for anosmia, 
when the patient lies down ; 
a little alcohol at bed-time, 
more especially for the aged, 
is an excellent " night cap," 
and when we find weakly 
persons complaining of want 
of sleep, we will do well to 
order a cup of milk or a little 
beef-tea, or other simple nour- 
ishment, to be taken at bed- 
time, or placed by the bed- 
side for use in the early morn- 
ing hours, when the power of 
life begins to flag. 

Suitable bed-room arrange- 
ments are very important, as 
some persons are at once 
awakened by the faintest ray 
of light. Some like a hard 



80 PURGATIVES. 

ending in death. Sleep, again, bed, others, a soft ; according 

is promoted by the removal to their personal habits, 
of everything which excites 
the patient. 

Thus, hyoscyamusor conia, These drugs have done 

or atropia, by stilling the wild good service in asylum prac- 

ravings of mania, may be tice. 
truly narcotic, and remedies 
of the next class are often ef- 
fective members of the major 
group, by lulling or removing 
pain, which made sleep im- 
possible. 

Anodynes. 

Physiological. Therapeutical. 

Anodynes act by lulling Of all anodynes opium is 
pain, probably by interfering the best, and more especially 
with the conducting power of morphia by subcutaneous in- 
sensory nerves. Opium pos- jection, which rarely fails to 
sesses this power, which is lessen, and often speedily re- 
absent in chloral, and then moves pain ; chloral only re- 
we have aconite, belladonna, moves pain during sleep, but 
chloroform, compound spirits curare is probably a true se- 
of aether, etc., which may dative. Local application of 
soothe locally, as well as con- anodynes is only serviceable 
stitutionally. in acute inflammation, neu- 
ralgia, rheumatism. 



PURGATIVES. 

Purgatives may be divided, first, into two classes depend- 
ing on their origin, and these are : — 

1. The inorganic substances, comprising chiefly the mer- 
curials and salines. 

2. Those derived from the vegetable kingdom, and which 
depend for their therapeutical action on the presence of resins 
or oils. 

Their actual modes of operation, however, are much more 
varied, and they will best be considered by division under 
various headings, according to their physiological and thera- 
peutical properties. 



PURGATIVES. 



81 



1. Laxatives. — These sub- 
stances act by causing a slight 
increase in the peristaltic 
movement of the intestines, 
with softening of the feces, 
which are then expelled in a 
solid and formed condition. 



2. Purgatives produce 
more decided effects both in 
stimulating movement and 
secretion ; but it is difficult to 
separate them entirely from 
either class No. 1 or No. 3. 



3. Drastic Purgatives. — 
These run by insensible gra- 
dations into the preceding 
class. Their action depends 
on an irritation of the mu- 
cous membrane of the intes- 
tines, and not only an actual 
increase of secretion from 
their glands, but the with- 
drawal of watery fluids from 
the blood. An overdose, 
therefore, may be attended 
by serious depression, discom- 
fort, and even by death from 
inflammation of the bowel. 



1. The principal of these 
are sulphur, castor-oil, mag- 
nesia, etc. ; but in addition 
to actual drugs we may in- 
clude various articles of diet, 
as oatmeal, brown bread, 
whole flour, figs, prunes, etc., 
which act purely mechani- 
cally. 

Laxatives are useful when- 
ever we desire a mild and un- 
irritating effect, as in simple 
constipation from dyspepsia, 
pregnancy, or convalescence 
from acute diseases, seden- 
tary habit, and other causes. 

Castor-oil acts well in the 
early stages of diarrhoea, by 
sweeping away the irritating 
cause. 

2. Rhubarb, senna, aloes, 
and jalap are reckoned among 
the chief of these, and they 
are used in various dyspeptic 
conditions, rhubarb being 
more especially stomachic, 
and aloes emmenagogue, in 
its properties. 

3. In this class we include 
jalap, scammony, colocyntli, 
gamboge, and croton oil, and 
they are principally used 
either in obstinate constipa- 
tion, or to produce a deriva- 
tive or species of counter-irri- 
tant effect in various forms of 
brain disease. 



82 



PURGATIVES, 



4. Hydragogue purgatives 
cause very free secretion from 
the mucous membrane of the 
bowels, and empty the veins 
by withdrawing fluids from 
the blood. 



5. Saline Purgatives. — 
We shall, when treating of 
magnesium sulphate (Epsom 
salt), consider the action of 
this class, a*nd point out 
how, from their low diffusive 
power, they pass with diffi- 
culty into the blood, and how, 
whilst in the intestine, they 
not only absorb, retain, and 
carry away the watery fluids 
which they find in the intes- 
tine, but also directly with- 
draw fresh supplies from the 
blood itself. 

6. Cholagogue Purgatives. 
— Much experiment has re- 
cently been expended on the 
action of this class, and those 
recently conducted on im- 
proved principles by Prof. 
Rutherford have given us 
very precise and reliable in- 
dications for practice. Cho- 
lagogues have been held to 
act either by directly stimu- 
lating the secretion of bile, 
or by increasing the efficiency 
of the bile-expelling mechan- 
ism ; and as the elaborate 
important experiments of 
Rutherford have only refer- 
ence to the first action, he 
prefers to use the term hepa- 
tic stimulant, although any 



4. These are elaterium, 
cream of tartar, etc., and they 
are most useful in ascites and 
other dropsical conditions, 
and for the relief of a feeble 
and laboring heart by dimin- 
ishing the actual volume of 
the blood. 

5. Sulphate of magnesia 
and many of the salts of pot- 
ash and soda must here be in- 
cluded. They are best given 
in a state of free dilution, and 
make very efficient habitual 
purgatives, more especially in 
the form of various natural 
purgative waters, such as 
Friedriehshall, Pullna, and 
Congress water. 



6. The principal members 
of this group are mercury, 
podophyllin, rhubarb, aloes, 
jalap, mercuric chloride, col- 
chicin, euonymin, iridin, 
sanguinarin, ipecacuan, colo- 
cynth, sodium sulphate, so- 
dium salicylate. They are 
used for the relief of various 
functional affections of the 
liver, to remove what is com- 
monly known as " bilious- 
ness," and to obviate portal 
congestion. 



PURGATIVES. 



83 



explanation of the action of 
this class of remedies must 
be almost purely conjectural. 
Rutherford believes that the 
effect is due to "a direct ac- 
tion of their molecules upon 
the hepatic cells or their 
nerves." 

It is interesting to observe, 
as noted by Rutherford : a. 
" That when a substance 
produces purgation, but does 
not stimulate the liver, it di- 
minishes the secretion of 
bile. b. That when a sub- 
stance stimulates the liver as 
well as the intestinal glands, 
a moderate dose increases 
both the hepatic and the in- 
testinal secretion, the effect 
on the former being more 
marked in the earlier part of 
the experiment, and dimin- 
ishing as the purgative effect 
increases, but an excessive 
dose by producing a violent 
purgative effect early in the 
experiment, may occasion 
nothing but diminished secre- 
tion of bile." 

In addition to drugs be- 
longing to the actual purga- 
tive class, we have many 
indirect remedies which act 
with considerable efficiency. 
Thus we may use enemata, 
cold to the abdomen, me- 
chanical kneading of the pa- 
rietes, or electricity, in order 
to stimulate the muscular 
tissues to contraction ; or we 
may cause a purgative action 
by relieving spasm. 



Among the stimulating 
class we may mention 
strychnia, mix vomica, er- 
got, and the ferrous sulphate, 
and these are very efficient, 
in combination with mild 
purgatives, where constipa- 
tion depends on a lax or 
weakened state of the intes- 
tinal walls. 

When spasm or irregular 
contraction prevents free 
action of the bowels, we 



84 



STIMULANTS AND SEDATIVES. 



must have recourse to opium, 
belladonna, or the lead ace- 
tate, which, under these con- 
ditions, may be looked upon 
as true cathartics. 

In administering purgatives, we must consider the various 
parts of the intestinal canal on which they act. Thus senna, 
jalap, etc., act on the small intestine, aloes on the large, 
podophyllin on the duodenum, etc. We must also consider 
the time of their administration, as we iind that the slowly 
acting resinoid substances are best given at night or before 
dinner, whereas the salines are best taken on an empty 
stomach, and more especially before breakfast. The mode 
of administration is also worthy of note, the resinoids being- 
best taken in the form of pill, whereas the salines act best 
in solution with free dilution and in combination with bitters, 
iron, or sulphuric acid. 

STIMULANTS AND SEDATIVES. 

Stimulants and sedatives are so directly antagonistic in 
nature that the most satisfactory scheme of their action will 
be presented by direct contrast in parallel columns, accord- 
ing to the plan adopted generally throughout these pages. 



I. General Stimulants. 

As the principal members 
of this srroup we may mention 
alcohol, opium, and the an- 
aesthetic vapors, which, whilst 
stimulant in small, are nar- 
cotic in large doses ; the 
ethers and ammonia, which 
are called diffusible because 
rapid elimination prevents 
any marked display of their 
stupefying qualities. We 
may refer to the article on 
alcohol for directions as to 
the use of stimulants in 
health and disease. Then 



I. General Sedatives. 

The stimulating drugs in 
the opposite column, when 
carried beyond a certain 
point, cause a sedative or 
soothing action, and run by 
insensible degrees into the 
truly narcotic class of reme- 
dies. Over-stimulation pro- 
duces exhaustion and indi- 
rectly a sedative action. 



STIMULANTS AND SEDATIVES. 



85 



again, the cold douche, coun- 
ter-irritation, and electricity 
may act as powerful stimu- 
lating agents under certain 
conditions. 



II. Special Stimulants. 

1. To the nervous system. 
Alcohol, ether, and opium un- 
doubtedly stimulate the brain, 
causing greater intellectual 
activity and an increased flow 
of ideas, occasionally some- 
what irregular in form. 
Phosphorus may be ranked 
under this heading, and digi- 
talis may improve the func- 
tions of the cerebral hemis- 
pheres by the more regular 
supply of blood which its 
tonic influence on the arterial 
system provides. 

The spinal cord is directly 
and powerfully stimulated by 
strychnia, and in the lower 
animals by morphia ; whilst 
ergot and belladonna, by con- 
tracting its vessels, may help 
in removing various condi- 
tions of debility. Certain 
nervous centres are stimu- 
lated by certain drugs. Thus, 
atropia stimulates the respi- 
ratory centre, the indirect 
emetics stimulate the vomit- 
ing centre, strychnia the vaso- 
motor centre, etc. The ear- 
ringing property of quinine 
is probably due to an irrita- 
tive action on the auditory 
nerve, digitalis stimulates the 
vagus, whilst jaborandi and 
8 



II. Special Sedatives. 

1. Nervous system. The 
best sedatives to the brain 
are undoubtedly those drugs 
which diminish its blood sup- 
ply and so cause sleep. Co- 
nium is held to exert a spe- 
cially sedative effect on the 
great motor ganglia. 



The principal spinal seda- 
tives are Calabar bean, bro- 
mide of potassium, chloral, me- 
thyl conia, and gelseminum, 
which powerfully depress the 
reflex functions of the cord, 

The respiratory centre is 
depressed by chloral hydrate, 
hydrocyanic acid, amyl ni- 
trite, aconite, opium, etc. 

An interesting selective ac- 
tion of a sedative or paralyz- 
ing nature is exerted by the 
following drugs on the fol- 
lowing nerves. Atropia para- 
lyzes the intra-cardiac inhib- 
itory apparatus and the ter- 
minal fibres supplied by the 
third nerve to the iris. Co- 
il ium paralyzes the third 



86 



muscarin confine that action 
to the intra-cardiac inhibitory 
apparatus. The sialagogue 
action of jaborandi is be- 
lieved to be due to a stimu- 
lation of the periphery of the 
salivary nerves. 

2. Cardiac and Vascular 
Stimulants. The general 
stimulants already enumerat- 
ed undoubtedly stimulate the 
heart, and the class of drugs 
of which digitalis is the type 
have been already considered 
under cardiac tonics. Opium 
is decidedly a vascular stimu- 
lant. 

8. Digestive and Secretory 
Stimulants. The stomach 
may be stimulated by ginger, 
capsicum, pepper, and the 
like ; whilst cholagogues, diu- 
retics, purgatives, and dia- 
phoretics may be held to 
stimulate the liver, kidneys, 
intestines, and skin, by pro- 
moting or exciting their re- 
spective functions. 



nerve, gelseminum the sixth, 
and croton chloral the fifth. 
Atropia also exerts an inhib- 
iting influence upon the se- 
cretory nerves of the sub- 
maxillary gland, etc. 

2. Cardiac Sedatives. The 
principal cardiac sedatives or 
depressants are aconite, vera- 
trum viride, tobacco, colchi- 
cum, chloral, chloroform, and 
potassium nitrate. 



8. Digestive and Secretory 
Sedatives. A sedative ac- 
tion on the stomach may be 
produced by hydrocyanic 
acid, bismuth, and alkalies, 
generally in small doses. 



TONICS. 

The word tonic is undoubtedly vague from the strictly 
scientific stand-point, but we may congratulate ourselves that 
zeal for more precise nomenclature has not yet succeeded in 
depriving us of a term which has now included so many asso- 
ciations of an empirical kind. The best example of tone 
probably is the gentle and permanent contraction of the mus- 
cular tissue, which is kept up in the healthy body by the 
central nervous system, and which, when suspended by dis- 
ease, is familiar to us all in the flaccid and powerless limb of 
paralysis, and an appropriate remedy is found in electricity, 
which improves the nutrition and status of the part. We have 
vascular tone also, in which the due calibre of the arteries is 



87 



regulated by the action of the vaso-motor nerves, and were 
we asked to name two tonic remedies which reinforce these 
important functions, we might unhesitatingly point to strych- 
nia, which aids the nervous tone, and digitalis, which raises 
the arterial tension by stimulating the vaso-motor centre. 
But treating our heading in a more general sense, we are 
justified in calling anything a tonic which improves the gen- 
eral health, and thus an emetic, or a purgative, or a nar- 
cotic, or a sedative, may really have tonic properties by 
removing obstruction or irritation and giving rest to fatigued 
or worn-out organs. The best of all tonics, after all, are 
those which cannot well be included in any therapeutical 
tables; for what can equal the bracing properties of sea- 
bathing, of change of air and scene, of the keen whiff of 
exhilarating ozone on a Swiss glacier or a Scotch moor, of a 
day's hunting or shooting, or a ramble along a good trout 
stream when fish are well on the take ? A good dinner, 
with a glass of good wine, cheerful society, the stimulus of 
hope, even the rousing effect of a sudden reverse of fortune, 
may be often more successful than mere drugs ; but in con- 
sidering the varying modes of treatment for debility in its 
many forms, we may usefully divide our therapeutic resources 
in the following way : — 



I. Nervin 

Physiological. 

1. First among these we 
may rank agents acting di- 
rectly *on the brain, reducing 
its blood supply and giving 
it rest. 



2. Then again, certain 
drugs act on special centres; 
thus, strychnia and digitalis 
stimulate the vaso-motor cen- 
tre, atropia the respiratory 
centre; and strychnia stimu- 
lates the spinal cord. 

Finally, we have those 
substances generally known 



e Tonics. 

Therapeutical. 

1. Under certain condi- 
tions of mental excitement 
or worry or debility, no tonic 
can be so good as a sound 
night's rest, and the narcotic 
class of remedies act well by 
supplying this. 

2. Strychnia and nux vom- 
ica are of great service by 
aiding the circulation through 
the vaso-motor centre, and 
helping the spinal cord to re- 
sume its full functions when 
it is weakened by any debili- 
tating cause. The nervine 
tonics are used not only in 



T N T S . 



under the somewhat vague 
title of nervine tonics. These 
are principally metals, such 
as arsenic, phosphorus, zinc 
oxide, and zinc sulphate; but 
quinine and ammonium chlo- 
ride have also good right to 
be included in the list. 



simple debility, but in spe- 
cial conditions of nervous 
weakness. Thus quinine, 
arsenic, and even ammonium 
chloride are of service in neu- 
ralgia, probably by giving in- 
creased tone to sensory nerves; 
the zinc salts are useful in the 
irregular muscular contrac- 
tions of chorea, and in the 
loss of the presiding nervous 
control which characterizes 
hysteria. 



II. Vascular Tonics. 



This class of remedies may 
act in three different ways. 

1. On the heart itself, 
bracing up and improving 
the condition of tone of its 
muscular fibre and slowing 
its action so as to give it in- 
creased rest. Digitalis stands 
first on the list. 

2. Those which act more 
particularly on the vessels, 
raising arterial tension by 
contracting the muscular tis- 
sue of which their walls are 
largely composed. Here 
ajmin digitalis comes into 
play, but we also have ergot, 
belladonna, etc. etc. 

3. Those which act di- 
rectly on the blood, increasing 
the number of red corpuscles 
and the amount of hiemoglo- 
bin which they contain. Iron, 
phosphorus, arsenic, and cod- 
liver oil have been proved, 
by careful investigations and 



1. We see the great bene- 
fit of this division more espe- 
cially in heart disease, where 
the pulse is feeble and irregu- 
lar, and infunctional derange- 
ment of cardiac action from 
feebleness of the muscular 
structures of the heart. 

2. These also act well in 
improving the general tone 
of local circulation, bracing 
up the vessels, and removing 
oedema and passive conges- 
tion. 



3. In anaemia, where the 
blood is poor in red corpus- 
cles and haemoglobin, in chlo- 
rosis, in the debility follow- 
ing loss of blood, etc. etc., 
these hsematinic remedies, 
as they have been called, are 
of essential service, whilst in 



TONICS. 



89 



by direct measurement, to 
have this property [which 
has also been shown by Keyes 
to belong to mercuric bichlo- 
ride in small doses J. 



neuralgia they act well by 
giving the enfeebled sensory 
nerves the healthy stimulus 
of better .blood. 



III. Digestive Tonics. 



Of the importance of this 
division there can be no doubt, 
when we consider that life 
itself, as well as sound health, 
depend on the consumption 
and due assimilation of a 
well-arranged dietary. Bit- 
ters are generally looked 
upon as the type of tonics, 
and there is no doubt that 
they increase the feeling of 
appetite and augment the 
secretion of saliva, and possi- 
bly that of the gastric juice. 
Then, again, the best tonic 
to an irritable stomach may 
be remedies such as bismuth 
and hydrocyanic acid, which 
calm and soothe, and enable 
the mucous membrane to re- 
sume its function. Gentle 
purgatives may also act as 
tonics, and acids and alkalies, 
which both check inordinate 
acid secretion and encourage 
its flow. 



In general debility and 
feebleness, convalescence 
from acute illness, and want 
of tone, we know Iioav much 
more hopeful we become 
when our patient is able to 
relish and digest his food, 
and we also know how great 
is the aid given by small 
doses of alcohol with the 
meals, in helping the weak 
stomach to do its work. For 
irritable dyspepsia, with a 
red. tongue, the ordinary 
tonics only do harm, and 
when the tongue is foul and 
loaded, a mild course of pur- 
gatives will remove unhealthy 
mucus and enable digestion 
to be satisfactorily accom- 
plished. 



8* 



90 



ACTION OF THERAPEUTIC AGENTS. 



[SUMMARY OF THE ACTIO X OF THERAPEUTIC 
AGENTS. 



Remedies may be used with a therapeutic effect for the 
purpose of favorably modifying : — 

Environment (Antiseptics, and hygienic measures). 

Food. 
Appetite. 
Digestion. 
Absorption. 
Nutrition [ Secretion. 

Blood-crasis. 
Respiration. 
Bodily heat. 
Organic status. 



Innervation 



Circulation 



Functional 
activity 
(specifically). 



Sensation (general and special). 
Motility. 
[ Condition of nervous structure. 

( Stimulant. 



Action of heart 



( Sedative. 



j Arterial contraction. 
[ Volume of blood. 

Stomach. f A - 

vo 



Liver. 
| Kidneys. 
<{ Heart. 

Lungs. 

Nervous struc 
tures, etc. 



mitmg. 
Purging. 



I Counter-irritation, etc. 



They also indirectly influence development, and in an 
unknown manner act upon certain morbid states, as cin- 
chona in malaria, and mercury in syphilitic dyscrasia. 

The following classification (especially that of Dr. H. C. 
Wood) will probably be found to be as useful as any that 
has been offered : — 



CLASSIFICATION OF DRUGS. 



91 



CLINICO-PHYSIOLOGICAL CLASSIFICATION 
OF DRUGS. 1 

I. Local, or Non-systemic Remedies. 
Anthelmintics. 
Chemical antidotes. 

f Absorbing. 



Disinfectants «{ 



Stomachics 



< 



Antizymotic. 

Dehydrating. 
Oxidizing. 
Antacids. 
Carminatives. 
[_ Digestants. 

II. Substances which act en the solids and fluids of the body 
a. Systemic Remedies. 
Class I. Astringents. 
II. Tonics. 

III. Cardiac stimulants. 

IV. Cardiac sedatives. 
V. Antispasmodics. 

VI. Analgesics. 

VII. Mydriatics. 

VIII. Anaesthetics. 

IX. Excito- motors. 

X. Depresso-motors. 

XI. Alteratives. 



C Nervines. 
•{ Anodynes. 
[ Hypnotics. 

f Special stimulants 
(_ and sedatives. 



b. Organic 


Remedies. 






Class I. 


Emetics. 


Class IX. 


Errhines. 


II. 


Cathartics. 


X. 


Epispastics. 


III. 


Diuretics. 


XL 


Rubefacients 


IV. 


Diaphoretics. 


XII. 


Escharotics. 


V. 


Expectorants. 


XIII. 


Demulcents. 


VI. 


Emmenagogues 


XIV. 


Emollients. 


VII. 


Oxytocics. 


XV. 


Diluents. 


VIII. 


Sialagogues. 


XVI. 


Protectives.] 



1 [The student will find it a good practice to set down these head- 
ings on paper, and afterwards insert from memory as many as pos- 
sible of the various drugs under their proper headings in accordance 
with the description of their effects given in the following pages. 
In discussing the remedies systematically in this work, it has been 
thought best not to follow any therapeutical classification, as none 
that have been offered are free from objection, and the advantages 
of an alphabetical arrangement for the convenience of reference are 
too obvious to demand discussion.] 



REMEDIES 



COMPRISED ]>" THE 



PRIMARY LIST OF THE UNITED STATES 
PHARMACOPOEIA. 



ABSINTHIUM— WORMWOOD. 

[Tlte tops and leaves of Artemisia Absinthium, U. S.~\ 

Wormwood was formerly used as a bitter tonic and an- 
thelmintic, but it has now quite disappeared from practice. 
Its prolonged use as a beverage, in the form of liquor, has 
been shown to produce a condition of enfeeblement and 
irritability of the nervous system, with a tendency to epi- 
leptiform convulsions. 

[In combination with other herbs, it is occasionally used 
in domestic practice under the name of German Tea as a 
tonic ; and in the form of infusion it is sometimes given for 
intestinal worms in children. Wormwood entered into the 
composition of the once famous " thieves' vinegar," Vhtaigre 
des qnatre voleurs (Ni/sten, Diet, de Med.). The plant con- 
tains a volatile oil, which gives name and flavor to absinthe.'] 



ACACIA—GUM ARABIC. 

[A gummy exudation from Acacia vera and other species 
of Acacia, U. S. 

Officinal Preparations, U. S. 

Syrupus Aeaeiae, used as a vehicle. 
Mueilago Aeaeiae, used as a vehicle. 

Also enters into Mistura Amygdala?, Mistura Cretan, and 
Mistura Glycyrrhizaj Composita, and is used as an excipient 
and dusting-powder for pills.] 



94 VINEGAR — ACETIC ACID. 

Gum is demulcent, and in the form of mucilage is much 
used for the suspension of bulky and insoluble powders, as 
well as to prevent the precipitation of the resin, which en- 
sues when such substances as tincture of myrrh, tinct. can- 
nabis Indicre, etc., are added to water. 

[Gum-Arabic water may be given as a demulcent drink 
in fevers, in angina, in g astro-enteric inflammation, and 
dysentery. It has some slight nutritive properties.] 



[ACETUM— VINEGAR. 

Impure dilute acetic acid prepared by fermentation, U. S. 
Officinal Preparations, U. S. 

Aeetum De still at urn (used in making Tinctura Opii 
Acetata). 

External and Internal Uses. 

Vinegar, more or less diluted, is a favorite domestic appli- 
cation in headache, sprains, or bruises, and sun-burn; it is 
also used as a clyster against ascarides. It may be given as 
a refrigerant drink in fevers; and in these cases it is fre- 
quently applied to the surface of the body, with a sponge, as 
a means of reducing high temperature. In small amounts 
vinegar aids digestion, but in excess it is said to produce de- 
generation of the gastric tubules and fibroid thickening of the 
stomach. It is supposed to act on the blood by influencing its 
crasis, and reducing the proportion of fibrin. It has been 
found an efficient remedy in scurvy, in combination with 
nitre (*j to Oj), of which an ounce may be given four times 
daily.] * 



ACIDUM ACETICUM— ACETIC ACID. 

[Acetic acid of specific gravity, 1.047 U. S. 

Officinal Preparations, U. S. 

Acidum Aeetieum Dilutum (f^ij in Oj). Dose 
f5j-ij (4 to 8 gm.). 

Also enters into Aeetum Lobelia?, Aeetum Opii, Aeetum 
Sanguinaria?, Aeetum Scillre (Syrupus Scillse), Emplastrum 
Ammoniaci, Extractum Colchici Aeetieum, Extractum 



ACETIC ACID. 95 

Ergotse Fluidum, Liquor Ammonii Acetatis, Syrupus Allii, 
Potassii Acetas, and Zinci Acetas. 

Symptoms of Poisoxing. 

Great heat and burning pain in the stomach, vomiting a 
sour liquid, purging, convulsions, coma, and death. 

Mouth and fauces brownish, lingual papillae swollen, 
sloughing of mucous membrane of pharynx, stomach livid 
or blackened, capillaries injected. 

Axtidotes. 

In poisoning by acetic acid, alkalies or their carbonates 
may be given, properly diluted, and vomiting encouraged by 
large draughts of warm water containing milk or soap.] 

External Action. 

Strong, or glacial, acetic acid is a favorite and very suc- 
cessful application to warty growths, whether of venereal 
origin or not. The little tumor is touched several times 
with a glass rod, or brush, or a piece of wood, dipped in the 
acid, care being taken that none of the fluid trickles down 
over the neighboring structures. A few repetitions of this 
process will generally prove effectual. It is also topically 
used in some obstinate forms of skin disease, and more espe- 
cially the varieties of tinea comprised under the term ring- 
worm. The acid probably acts by directly attacking and 
destroying the parasitic growth on which the troublesome 
affections depend. Acetic acid is also occasionally applied 
to corns. 

Internal Use. 

Acetic acid is seldom used internally, although it forms 
an agreeable and effectual remedy for the checking of night 
sweats, and Graves used thus to prescribe it. 

The varieties of acetic acid are: Acidum aceticum, from 
which are prepared acidum aceticum dilutum and oxymel, 
the doses being of acid. acet. dil. f 5j to f'3ij (4 to 8 gm.), 
oxymel [Br.] f 5j to f 5ij (-1 to 8 gm.) ; and acidum aceticum 
glaciale. Then we have vinegar, the strength of which cor- 
responds pretty accurately with the dilute acid, and which 
is purely a domestic remedy for headache, hysteria, and other 
allied conditions. 



96 CARBOLIC ACID. 

[(St. John Long's Liniment.) A favorite liniment 
is made as follows : to twelve fluidraehms of rose-water add 
four fluidraehms of acetic acid in a bottle, then in a graduated 
measure put three fluidounces of oil of turpentine, and forty 
minims oil of lemon. Rub the yelk of one ego; in a mortar 

J DO 

with two drachms of the acidulated rose-water to a smooth 
uniform mixture, which transfer to an eight-ounce bottle, 
and add to it three drachms of the oil mixture, shaking the 
mixture vigorously. In like manner alternate the remainder 
of the two, shaking well after each addition, until all has 
been added. This emulsion will stand for a long time with- 
out separating. (J. B. Moore, in Proceed. Am. Pharm. 
Jsso., 1881, p. 74.)] 



[Aeeta. 

The officinal Vinegars are: — 

Acetum Destillatum. Acetum Sanguinarice. 

" Lobelias " Scilke.] 

" Opii. 



ACIDUM ARSENIOSUM— ARSENIOUS ACID. 
[Sublimed arsenious acid in masses, U. S. See ARSENIC] 

ACIDUM CARBOLICUM— CARBOLIC ACID. 

[Syn. — Phenic acid. Phenylic alcohol. 

A solid substance obtained from the products of the distillation of coal- 
tar, between the temperatures of 300° and 400°, U. S. 

Dose, gtt. i-ij (.06 to .13 gm.), in pill or solution. 



[ACIDUM CARBOLICUM IMPURUM. 

Impure carbolic acid, U. S. ( Used only as an external remedy or for 
disinfecting purposes.) 

Officinal Preparations, U. S. 

Glyeeritum Acidi Carbolici. (Acid |ij by weight, 
glycerin half a pint.) Dose, n^v-x (=.30 to .65 gm.). 

Unguentum Acidi Carbolici (3j to gj). 

Suppositoria Acidi Carbolici (each gr. j). 

Aqua Acidi Carbolici. (Glycerite of carbolic acid 
f3x, water q. s. to Oj.) 



CARBOLIC ACID. 



97 



Poisoning. 

In poisonous doses it causes burning and pain in the stom- 
ach, mucous vomiting, clammy, cool skin, difficult breathing, 
insensibility, contracted pupils, collapse, and death. Post- 
mortem examination discloses catarrh of the mucous mem- 
brane of the stomach, inflammation of the kidneys, dark and 
imperfectly coagulated blood. 



Antidotes. 

Saceharate of calcium (may be extemporaneously pre- 
pared by adding calcium hydrate 1 pt. to sugar 3 pts.), cal- 
cium carbonate, and calcined magnesia, in lime-water, are 
probably the best antidotes. Alkalies, soap, or the fixed oils 
may be given, with demulcent drinks, and the stomach 
evacuated with a pump or siphon, as the local effect of the 
acid will generally prevent emetics from acting. Atropia 
and cardiac stimulants are required to obviate the tendency 
to collapse. Nitrite of amyl might be cautiously inhaled ; 
or an intravenous injection of diluted aqua ammonire admin- 
istered.] 

Local Action. 



Physiological Effects. 

Carbolic acid is, in the 
first place, an antiseptic, from 
its power of destroying the 
minuter forms of animal and 
vegetable life. 



Carbolic acid is an irri- 
tating substance, and, if ap- 
plied sufficiently long to the 
skin, will cause sloughing. 

It has, however, undoubted 
anaesthetic properties. 



Therapeutical. 

It is therefore much used 
as an antiseptic and deodor- 
ant for the treatment of ill- 
smelling drains, etc., or to 
destroy the infectious pro- 
perties of various secretions 
or discharges from the sick. 
It ma)' aiso be useful as an 
injection or lotion to foul 
sores. 

Although carbolic acid 
may be of use in correcting 
fetor, it is too irritating to 
-make a good, lotion for 
wounds or ulcers [unless pro- 
perly diluted with oil (1 to 
24) or water (3j to Oj), 
when it forms an efficient 



98 



CARBOLIC ACID. 



R. 



It is also readily absorbed 
through the skin, children 
being especially susceptible 
to its action, and idiosyn- 
crasy here playing a promi- 
nent part. 



dressing]. It has been used 
as a caustic in some ulcera- 
tive affections, as lupus. It 
has been recommended as 
a local anaesthetic during 
small operations, and to dead- 
en the pain of some caustic 
applications. [The pain of 
opening a, felon may be great- 
ly reduced by previously im- 
mersing the finger for a few 
minutes in a 3 to 5 per cent, 
solution of carbolic acid.] 
It is a good application in 
tinea tonsurans, both de- 
stroying the microspores and 
preventing their develop- 
ment ; but as re-development 
rapidly takes place, we must 
apply our remedy every six 
hours, and continue doing so 
for a fortnight after the ap- 
parent cure. A good for- 
mula being — 

Sulphuris praecipitat., 

Zinci oxidi aa5J ; or 4 Gm. 
Olei olme fj ; 32 " 

Acidi carbolicigr.xvj. 1 00 " 

M. To be rubbed in for a few 
minutes. (R. Lee.) 

We must therefore remem- 
ber that symptoms of poison- 
ing may readily be produced 
by the application of carbolic 
acid over any considerable 
cutaneous area, and that at 
least one death has been di- 
rectly due to Listerian pre- 
cautions. 



Antiseptic System of Prof. Lister. 

Its principal application, The acid itself, being ex 

however, in surgery, is in tremely irritating, 



is pre- 



CARBOLIC ACTD. 



99 



enabling us to carry out tlie 
far-famed antiseptic system 
of Prof. Lister. 

This eminent surgeon, 
adopting the views of Pas- 
teur, and believing that sup- 
puration, pyaemia, and vari- 
ous other inconveniences con- 
nected with open wounds, 
arise from the irritation of 
minute germs contained in 
the air, has devised a process 
in which the atmospheric air, 
before reaching the raw sur- 
face, is filtered through car- 
bolic acid and thus deprived 
of its irritating properties. 



vented from coming in con- 
tact with the wound or sore 
by a protection of oiled silk, 
over which are superposed 
several layers of gauze im- 
pregnated with paraffin 16 
parts, resin 4 parts, and car- 
bolic acid 1 part ; and this 
dressing need not necessarily 
be changed oftener than 
every two or three days. 

Mr. Lister prevents the 
access of air during opera- 
tions by surrounding the part 
with an antiseptic atmo- 
sphere, composed of a sprayed 
watery solution of carbolic 
acid of 1 to 40, and the in- 
struments and fingers of the 
surgeon are carefully washed 
with carbolized oil, whilst 
the arteries are tied with car- 
bolized catgut ligatures, cut 
off short. By adopting these 
precautions, and attending 
most rigorously to the care- 
ful dressing of wounds, he 
has obtained excellent re- 
sults, not only after ordinary 
operations, but in chronic 
abscesses wherever situated, 
compound fractures, and va- 
rious diseased conditions con- 
nected with joints, whose 
cavities he is enabled to 
open and explore with per- 
fect safety. 



Internal Action. 

Carbolic acid, if adminis- Carbolic acid has, in seve- 

tered in sufficient quantity, ral reported cases, caused 
is very poisonous in its ope- death by being drunk in 



100 



CHROMIC ACID. 



ration, causing failure of the 
heart's action, hurried and 
embarrassed breathing from 
irritation, and then paralysis 
of the respiratory centre in 
the medulla oblongata, spinal 
convulsions, gastro-intestinal 
irritation, lowered tempera- 
ture, and albuminuria. Its an- 
tiseptic properties sufficient- 
ly explain its internal use. 



ABSORPTION AND MO 



mistake for beer, or by being 
incautiously applied to the 
skin. ■ The best antidotes are 
olive oil and saccharated lime. 
It is occasionally given 
internally to counteractjtow- 
lence and sarcinous vomiting ; 
but the sulpho-carbolates,and 
more especially that of soda, 
are the most convenient forms 
for its administration in doses 
of 15 to 30 grains. It has 
been used successfully as an 
inhalation in bronchitis and 
whooping-cough. [Carbolic 
acid lias been recommended 
for tcenia, in pill form, taking 
three to five grains in the 
course of the day.] 

de of Elimination. 



Carbolic acid is rapidly absorbed, and quickly and entirely 
given off by the urine, to which it imparts a peculiar green- 
ish-black hue and its own peculiar smell. 



[ACIDUM CmiOMICUM— CHROMIC ACID. 
Potassii Biehromas. (See Potassium.) 

Effects and Uses. 

Chromic acid is an escharotic and antiseptic; it rapidly 
oxidizes organic matter and is the most energetic disinfectant 
known. A strong solution (gr. c. to i^j) may be applied 
with a glass rod, to destroy warts, condylomata, and excres- 
cences, or to reduce enlarged tonsils. Greatly diluted (gr. ss 
t0 t^j) it forms a detergent wash for mercurial stomatitis, 
scurvy, diphtheria, oedema of the glottis, ulcers, and phage- 
dena. On account of the difficulty of limiting its effect it 
should not be applied in substance, as when used in this 
manner to destroy warts on the fingers, it has been known to 
eat into the joint and require amputation of a phalanx.] 



CITRIC ACID. 101 

[ACIDUM CITRICUM— CITRIC ACID. 

Officinal Preparations, U. S. 

Syrupus Aeidi Citriei (5j in Oj). Used as a vehicle. 

Liquor Ferri Citratis, Liquor Magnesii Citratis, Liquor 
Potassii Citratis, Lithii Citras, Potassii Citras, and in pre- 
paring Ferri Pyrophosphas. 

Dose, gr. xx-xxx (= 1.30 to 2. gins.). 

Effects and Uses. 

As a refrigerant in fevers, citric acid solution is used in 
the form of lemonade, neutral mixture (liquor potassii citra- 
tis), or the citrates. It has been used in scurvy, liver disease, 
and rheumatism, and as an application to the throat in diph- 
theria (gr. viiss to fjj). Dr. H. Bence Jones believes that 
lemon juice and citric acid increase the acidity of the urine ; 
they consequently are contra-indicated in lithuria, and 
should not be given for a length of time, continuously, in 
the gouty diathesis.] 

External Use. 

Citric acid was proposed a few years ago as a soothing 
local application to cancerous sores. 

Internal Use. 

Citric acid is used chiefly as a cheap and convenient sub- 
stitute for lemon juice in effervescing draughts, which are 
very extensively prescribed on account of their cooling and 
refreshing properties in feverish conditions, and for the 
soothing influence of their carbonic acid when the stomach 
is irritable. 

Whenever lemon juice can be procured, it should be used 
in preference ; but at periods of the year when this fruit is 
out of season, citric acid will act well, and we here give a 
table from Squire, showing the proportions in which the acid 
and alkali should be prescribed to insure exact saturation. 

17grs. (1.12 

gm.) of citric- 
acid, or half 
a fluid ounce 
of fresh lem- 
on juice 



f 25grs. (1.6 gm.) bicarbonate of potassium. 
| 20 " (1.3 " carbonate of potassium. 
120 " (1.3 " bicarbonate of sodium. 
pq];iio ' ' 35 " (2.3 " carbonate of sodium. 

15 " (1. " carbonate of ammonium. 

13 " ( .78 " carbonate of magnesium. 



will 
neu- 
tralize 



9* 



102 DILUTE HYDROCYANIC ACID. 

Acidum tartaricum, being cheaper than citric acid, is 
often used to construct effervescing draughts. 



[ACIDUM GALLICUM. See GALLA.] 

ACIDUM HYDROCYANICUM DILUTUM— 
DILUTE HYDROCYANIC ACID. 

[A two per cent, solution in water of anhydrous Hydrocyanic acid, U. S. P. 

Officinal Preparations, U. S. 

Argenti Cyanidum. ) XT . , . . „ 
TT °j • /-i -j - JNot used interna ly. 

Hydrargyri Cyanidum. ) J 

Potassii Cyanidum, gr. T \ to T \ (.005 gm.). 

Ferri Ferroeyanidum, £ss (2 gm.). 

Potassii Ferroeyanidum, gr. x-xv (1. gm.). 

Poisoning. 

Prussic acid and the cyanide of potassium, in sufficient 
doses, are almost immediately fatal, so that in most cases no 
symptoms, except sudden collapse and death, are present. 
For a more detailed account of the effects, see page 10"). 

Antidotes. 

Chlorine or ammonia may be cautiously inhaled, ac- 
companied by cold affusions to the spine, and artificial 
respiration. As a chemical antidote, sulphate of iron (gr. 
x), and tincture of the chloride of iron (f3j)» dissolved in a 
fluid ounce of water, may be given immediately, to be fol- 
lowed by twenty grains of carbonate of potassium, likewise 
in solution, forming with the poison insoluble Prussian 
blue. Atropia is stated to be a physiological antidote. 

Tests. 

The peculiar bitter almond odor. A physiological test can 
be made by injecting some of the suspected fluid, hypoder- 
mically, into a rabbit, and observing its effects. When a 
little potassa is mixed with liquids containing this poison, 
and solution of the sulphate or sesquichloride of iron added, 
a grayish-green precipitate is thrown down — which deepens 
to a Prussian-blue tint ou addition of a few drops of sulphuric 
acid. The nitrate of silver produces a white (cyanide of 



DILUTE HYDROCYANIC ACID. 



103 



silver) precipitate ; which, after being washed and dried, and 
then held on a watch-glass over a flame, burns with a fresh 
rose-color, cyanogen being at the same time evolved. 

Sulphur Test Place two drops of a solution of hydrosul- 

phate of ammonia, containing an excess of sulphur, in the 
centre of a watch-glass, and invert it accurately over the 
vessel containing the poisoned liquid. Remove the glass in 
three or four minutes, and dry the moistened spot gently 
over a spirit-lamp. Let a drop of water fall on the white 
film, and then a drop of the perchloride of iron. If prussic 
acid be present, a blood-red solution (sulpho-cyanide of iron) 
is produced ; and this red color is discharged by the addition 
of one or two drops of a solution of corrosive sublimate. 

When a mixture is to be examined, containing matters 
from the stomach, etc , if alkaline, it must first be neutralized 
by addition of sulphuric acid, then one-eighth part cautiously 
distilled therefrom into a receiver immersed in some frigorific 
mixture; and the product may then be tested by nitrate of 
silver, etc., as above.] 



External Action. 



Physiological. 

Prussic acid applied to the 
skin in a concentrated form, 
may cause at first slight irri- 
tation, but secondarily dimin- 
ishes its sensibility, acting in 
some degree as an anaesthetic, 
probably from a benumbing 
influence on the extremities 
of the sensory nerves. 



Therapeutical. 

It is therefore used exter- 
nally, largely diluted, to re- 
lieve neuralgic pain and allay 
itching, more especially in 
skin disease. We may thus 
hope to alleviate the torment- 
ing irritation often attending 
'prurigo and eczema; but we 
must be careful never to let 
the lotion come in contact 
with any abrasion on the sur- 
face, as prussic acid is very 
readily and rapidly absorbed. 



Internal Action. 

Hydrocyanic acid, being the most powerful and speedy 
poison with which we are acquainted, requires to be pre- 
scribed with very great caution. 



104 



DILUTE HYDROCYANIC ACID. 



Physiological. 

1. On the Nervous System. 
— Prussic acid has some ef- 
fect on the brain, causing 
giddiness and slight stupor; 
the respiratory centre in the 
medulla next becomes weak- 
ened, and the motor nerves 
are more or less paralyzed, 
causing excessive muscular 
feebleness. 



2. The respiration be- 
comes slow and irregular, 
and finally ceases, death in 
cases of poisoning being 
generally due to suffocation. 
The sensory nerves are also 
enfeebled in their conducting 
power. 

3. Prussic acid has a pow- 
erful sedative action on the 
heart, the circulation becom- 
ing slow, feeble, and irregular 
under the influence of poison- 
ous doses ; and this arises 
both from an influence on the 
nerves and on the muscular 
structures of the heart itself. 

It also acts directly on the 
blood, combining with the 
haemoglobin of the red cor- 
puscles, and preventing them 
from properly fulfilling their 



llierapeuticaJ. 

1. It is used with great 
benefit in those forms of dys- 
pepsia attended with epigas- 
tric pain and vomiting fol- 
lowing food, and whether 
depending on gastric ulcer, 
or on mere irritation of the 
mucous membrane. It has 
also been given in ivhooping- 
congh ; but in my experience 
its action is here very uncer- 
tain, and I have been unable 
to satisfy myself that it is a 
remedy of much value. In 
some forms of chronic and 
spasmodic cough it does 
good, but it is essentially in 
dyspepsia that we obtain 
real advantage from its use. 



3. It has been successfully 
employed in nervous palpi- 
tation [or irritable heart]. 



DILUTE HYDROCYANIC ACID. 



105 



duty of carrying oxygen to 
the tissues. 

4. Prussic acid has no 
special influence on the tem- 
perature or on secretion, save 
that the saliva is generally 
increased in quantity. 

Prussic acid is very rapidly eliminated from the system, 
probably by the breath, and half an hour may be sufficient 
for this purpose, so that in a case of poisoning we may have 
good hopes of recovery, if we can sustain the powers of life 
during this period. 



Poisonous Effects In a 

large dose prussic acids kills 
immediately, the victim fre- 
quently uttering a loud cry, 
and expiring from cardiac 
syncope. If the quantity 
taken be smaller, symptoms 
of suffocation supervene from 
paralysis of the respiratory 
centre, and, if the process of 
poisoning be more gradual, 
from deficient supply of oxy- 
gen in the blood ; other symp- 
toms noted being convulsions, 
great muscular prostration, 
dilatation of pupils, and quick, 
feeble, irregular pulse. In 
fatal cases, post-mortem ex- 
amination shows nothing cha- 
racteristic. 

If the poison be taken in 
a concentrated form, death 
may ensue very rapidly, in 
probably less than a minute ; 
and Preyer, who has devoted 
special attention to the sub- 
ject, has observed a guinea- 
pig to be apparently dead one 
second after inhaling some 
gaseous acid, all efforts at 



Treatment Considering 

the great rapidity of the ac- 
tion of hydrocyanic acid, it 
is comparatively seldom that 
we have any opportunity of 
employing antidotes ; but sup- 
posing we see a case suffi- 
ciently early to do so, we 
should have vigorous recourse 
to cold affusion and the in- 
halation of ammonia and 
chlorine water. Artificial 
respiration should be then 
steadily persisted in, and if 
we can thus counteract the 
tendency to death by suffo- 
cation, and tide the patient 
over the' first half-hour, we 
may look forward to success, 
never despairing as long as 
the faintest pulsation can be 
felt in the heart. Secondary 
auxiliary means exist in the 
internal administration of am- 
monia, of chlorine water, or 
of carbonate of potash, fol- 
lowed by the mixed sulphates 
of iron, which convert the 
poison into Prussian blue ; 
and recently the subcutane- 



106 DILUTE HYDROCYANIC ACID. 

breathing having finally ous injection of atropia has 

ceased in fifteen seconds, been proposed as the true 
He, therefore, considers this physiological antidote, 
to be the most deadly mode 
of its administration ; but no 
matter through which chan- 
nel it enters the body, it 
speedily kills any animal, 
and, curiously enough, it is 
equally destructive to plants. 

Dose and Mode of Administration. 

One grain of anhydrous acid has caused death, and of 
this the preparation used in medicine contains 2 per cent., 
the old Scheele's, which is now obsolete, having contained 1 
per cent. 

In consideration of the rapid way in which the acid is 
thrown out of the system, we must repeat the dose fre- 
quently, from every hour to every three hours ; and it is 
well not to order too large a quantity at one time, not be- 
cause the acid tends to float on the top, as was formerly sup- 
posed, but because there is always a chance of an overdose 
being given through ignorance or carelessness. AVe may 
safely prescribe from 2 to 6 minims, beginning always with 
TTL j, suspending it if the patient complains of any constric- 
tion about the throat. For external use f 3ij may be dis- 
solved in 8 ounces of water or rose-water. 

R. Acidi hydrocyanioi diluti f.^ij ; or 8 Gm. 

GTycerinae f §.j ; " S2 " 

Aquae rosae q. s. ad ffviij ; " 250 " 

Misce, fiat lotio. 

S. To be applied with a soft sponge. 

In a case of troublesome itching. 

R. Acidi hydrocyanioi diluti Tt|_ xij ; or 175 Gm. 

Misturse amygdalae f§vj " 192| " 

Misce, fiat mistura. Capiat cochlearia magna duo tussi 



admodum ingravescente. 
For a case of irritable cough. 



ttlxxv ; 


or 


1 


5*s; 


" 


2 


f gj ; 


a 


32 


ad f §v r iij. 


a 


256 



60 Gm. 



R. Acidi hydrocyanioi dil. 
Bismuthi subnitratis 

Sy ru pi aurantii 
Infusi gentianse q. i 
Misce. Capiat cochlearia magna duo ter in die ante cibum. 

In a case of irritative dyspepsia. 



MURIATIC ACID. 107 

Or, a few drops of prussic acid may be added to the ordi- 
nary effervescing draught with good effect. 



[ACIDUM LACTICUM— LACTIC ACID. 

Officinal Preparation, U. S. 
Ferri Laetas. Dose, gr. v (.30 gm.). 

A syrupy, nearly transparent liquid, with slight odor and 
a very sour taste, obtained from sour milk. It has been 
found in the gastric juice, and may prove a useful addition 
to preparations of pepsin. It has been given in dyspepsia 
(dose f 5jjj i Q sweetened water at meal-time. Locally it 
has been employed (diluted four-fifths) as an application to 
the false membrane in crovp and diphtheria. 

According to Prout rheumatism is connected with an ex- 
cess of lactic acid in the blood ; and this fact accounts for the 
benefit derived from the alkaline treatment.] 



ACIDUM MURIATICUM— MURIATIC ACID. 

[An aqueous solution of hydrochloric acid gas, of the specific gravity 
1.1(50, U.S. 

Officinal Preparations, U. S. 

Aeidum Muriaticuni Dilutum (giv to Oj). Dose, 
TTvx-xx (.60 to 1.20 gm.). 

Also enters into the preparation of Aeidum Hydrocyani- 
cum Dilutum, Antimonii Oxidum, Calcii Phosphas Prrecipi- 
tata, Carbo Animalis Purificatus, Quiniae Sulphas, Strychnia, 
Sulphur Praecipitatum, and Aeidum Xitromuriaticum, Aqua 
Chlorini, Barii Chloridum, Ferri Chloridum, Liquor Arsenici 
Chloridi, Liquor Calcii Chloridi, Liquor Ferri Chloridi, 
Liquor Zinci Chloridi, Morphire Murias, and Resina Podo- 
phylli. 

Poisoning. 

Hydrochloric acid is a corrosive mineral poison. It causes 
a burning pain in the pharynx and epigastrium, strong styp- 
tic, acid taste in the mouth, much thirst, tense and frequent 
pulse, dry and hot skin, red glazed tongue, lips black. There 
is vomiting of blood and yellow matter, having the odor of 



108 MURIATIC ACID. 

the acid. Some of the vomit falling on a marble table 
causes foaming, from escape of carbonic acid gas. Cold 
sweats, delirium, and collapse terminate life. After death 
the parts in contact with the acid are stained and highly 
inflamed, and may be eroded. The vapor of ammonia pro- 
duces a characteristic white cloud of ammonium chloride. 
Nitrate of silver throws down a white precipitate, which 
afterwards becomes black. Only the presence of a large 
excess of free acid can establish the proof of poisoning by it. 

Antidotes. 

The same as for the other mineral acids : the alkalies and 
their carbonates, magnesia, soap, and bland drinks may 
be freely given. Muriatic acid stains the mouth and lips 
black, when taken undiluted.] 

External Use. 

Hydrochloric acid is a good form of application to diph- 
theria when it is used combined with equal parts of honey. 

Internal Use. 

Of all the acids used in medicine, this has undoubtedly 
the most beneficial action in dyspepsia, on account probably 
of its forming one of the normal constituents of the gastric 
juice. In cases where we suspect the formation of an exces- 
sive quantity of this fluid, we may, on the principles already 
enunciated, limit its secretion by prescribing the acid imme- 
diately before meals. When the epigastric pain comes on 
immediately after eating, the condition is no doubt due to 
an irritable or perhaps ulcerated condition of the stomach 
itself, and we may best, hope for success by carefully regu- 
lated diet and the use of bismuth, soda, or hydrocyanic acid. 
But when the pain does not set in with severity until from an 
hour to a couple of hours after food has been swallowed, the 
explanation probably is that an abnormal excess of gastric 
juice has been secreted, and a recurrence of this will best be 
checked by giving a little of the acid before meals. 

Hydrocliloric acid has also been much recommended by Dr. 
Chambers and others in typhoid fever, and it will generally 
be found that 20-minim doses of the dilute acid are very 
grateful to the patient, as quenching the thirst and moisten- 
ing the tongue. Dr. George Johnson has recently taken ex- 



NITRIC ACID. 109 

ception to tins, on the ground that the acid irritates the ulce- 
rated surfaces of Peyer's patches ; but not only does mere 
empirical experience demonstrate the Iiarmlessness as well as 
the convenience of this mode of treatment, but it is quite 
evident that the contact of at least three alkaline secretions 
must considerably modify the reaction of the acid before it 
reaches the seat of disease, and prevent it from retaining 
much irritating power, and I should therefore look upon these 
views of Dr. Johnson as having little practical value. 

Dose. 

In dyspepsia n^xx ad xxx (1.30 to 2. gm.). In typhoid 
fever nrxx (1.30 gm.) every two hours. 

]J. Acidi muriatici dil. tr^xx ; or 1130 Gm. 

Sp. chlovoformi Jr^xv ; " lj " 

Infusi gentianse f §j. 32 j " 

M. S. Ter in die. 

In dyspepsia. 



ACIDUM NITRICUM— NITRIC ACID. 

[Nitric acid of the specific gravity 1.420, U. S. 

Officinal Preparations, U. S. 

Aeidum Nitrieum Dilutum (fjiij to Oj). Dose, 
TTLiv-xv (.25 to 1 gm.). 

Also enters into Aeidum Nitro-muriaticum, Argenti Nitras, 
Bismuthi Subnitras, Liquor Ferri Nitratis, Liquor Hydrar- 
gyri Nitratis, Spiritus ^Etheris Nitrosi, Unguentum Hydrar- 
gyri Nitratis, and in the preparation of Aeidum Phosphori- 
cum Dilutum, Antimonii Oxidum, Bismuthi Subcarbonas, 
Cadmii Sulphas, Hydrargyri Oxidum Rubrum, Liquor Ferri 
Chloridi, Liquor Ferri Subsulphatis, Liquor Ferri Tersul- 
phatis, Liquor Zinci Chloridi, and Pyroxylon. 

Antidotes.* 

The same treatment as indicated for poisoning by Muri- 
atic Acid and the other mineral acids. Nitric acid stains 
the skin yellow.'] 

* The symptoms of poisoning are those of the corrosive mineral 
acids. 

10 



110 NITRO-MURIATIC ACID. 



External Use. 

Nitric acid is undoubtedly the best form of local applica- 
tion in all forms of sloughing or phagedenic ulceration, 
whether of venereal origin or otherwise. In these rapidly 
destructive forms of disease, we shall do well to place our 
patient under the influence of an anaesthetic, and then apply 
the strong acid freely and thoroughly to all parts of the 
affected surface, and we shall thus often succeed in arresting 
a process which would otherwise go on to severe and even 
fatal disorganization. 

It is also used locally in the treatment of piles, more espe- 
cially those flat irritable forms of tumor which do not come 
readily within the reach of the clamp or ligature. 

In the proportion of 10 or 20 minims to an ounce, nitric 
acid forms a good astringent lotion in cases of indolent or 
unhealthy sores ; and it has been recommended by Dr. 
Roberts, of Manchester, as an injection into the bladder for 
the solution of phosphatic calculi. 

Internal Use. 

Given internally, nitric acid has tonic properties, and, in 
combination with bark and opium, acts well in cases of foul 
or sloughing ulceration. Again, in constitutions broken 
down by syphilis or by chronic hepatic disease, we may very 
beneficially give our patient from 15 to 20 minims of the 
dilute acid three times a day, its action on the liver being by 
some supposed to have somewhat of a specific character. 

Gm. 



CO 



fy. Acidi nitrici diluti f gij ; or 8 
Tincturse opii li^xl ; " 2 

Tincturse cinchonas f §ss ; " 16 
Decocti cinehonae ad f §viij ; " 256 " 

Misce. Capiat cochlearia magna duo tev in die. 

In a case of foul or sloughing ulcer. 



ACIDUM NITRO-MURIATICUM— NITRO- 
MURIATIC ACID (3 to 5). 

[Dose, tt^v-x (.30 to .60 gm.), well diluted. 

Aeidum Nitro-muriaticum Dilutum (f|iv to 
Oj). Dose, ni x-xv (.60 to 1 gm.).] 

This is supposed to have some special action on the liver, 
and is most extensively used in chronic functional affections 



OXALIC ACID. Ill 

of that organ. It has also been highly recommended, in the 
form of bath, in various hepatic disorders in the proportion 
of G fluid ounces to each gallon of water. Or, internally — • 

R. Acidi nitro-muriatici diluti f 5ij ; 8! Gm. 

Extract, taraxaci f§ss; 16 1 " 

Spiritus chloroformi [Br.] f5' PS ! 6' " 

Aquae q. s. ad f§viij ; 256, " 

M. S. Capiat coclilearia magna duo ter in die. 

In a case of sluggish liver. 



[ACIDUM OXALICUM—OXALIC ACID. 

Officinal Preparation, U. S. 
Ferri Oxalas. Dose, gr. ij-iij (.12 to .20 gm.). 
Poisoning. 

Oxalic acid is a corrosive vegetable poison. It produces 
burning pain, nausea, and sometimes severe retching. Death 
may quickly ensue in collapse or convulsions, or may result 
from the subsequently developed severe gastro-intestinal in- 
flammation. 

Diluted it causes symptoms of cardiac paralysis. 

When death is produced by oxalic acid, in some cases no 
trace of the drug remains, or there may be nothing to show 
for it beyond inflammation of the alimentary tract. 

The test for oxalic acid is solution of calcium chloride, 
which causes a white precipitate (calcium oxalate). 

Antidotes. 

Magnesia and lime form insoluble precipitates with oxalic 
acid, therefore compounds containing chalk or magnesia 
would constitute chemical antidotes. Tooth-powder, lime- 
water, oxide and carbonate of magnesia, or k ' the scrapings 
of the ceiling with a fire-shovel," may be given with pro- 
priety in cases of poisoning ; which are not infrequent, since, 
owing to the resemblance between oxalic acid and Epsom 
salts, one maybe accidentally substituted for the other. The 
common names salts of sugar , and (in its combination with 
potassa) salts of lemon, tend to mislead the public as to the 
poisonous character of the drug. 



112 SULPHURIC ACID. 



Effects and Uses. 

Oxalic acid has been used, in small doses, internally, in 
scurvy and phthisis, but has nothing particular to com- 
mend it.] 



ACIDUM PHOSPHORICUM GLACIALE— 
GLACIAL PHOSPHORIC ACID. 

[Officinal Preparation, U. S. 

Acidum Phosphorieum Dilutum. Dose, n^viij- 
5J (.50 to 4. gm.).] 

This acid was formerly held to be of advantage in diabetes, 
but more recent investigation has shown that instead of di- 
minishing it actually tends to increase the amount of sugar 
given off by the urine. It therefore cannot be held to have 
any special significance from a therapeutic point of view, but 
may be adopted as an agreeable mode of introducing acid 
into the system, as its flavor is agreeable. We may take 
occasion, however, to mention a mistake which is not uncom- 
monly made in prescribing, and that is to prescribe phos- 
phoric acid with the view of obtaining the medical influence 
of phosphorus. Now it is well known that only from phos- 
phorus in a free condition do we obtain any real benefit, and 
of this phosphoric acid contains no trace. 

[It has, however, been used as a tonic and alterative in 
rickets and scrofula; and is an excellent adjuvant to cough- 
mixtures, or tonics, for elderly patients.] 



ACIDUM SULPHURICUM— SULPHURIC ACID. 

[Syn. Elixir of Vitriol. 
Sulphuric acid of the specific gravity 1.843, U. S. 

Officinal Preparations, U. S. 

Aeidum Sulphuirieum Aromaticum (f"5 v J m 
Oj). Dose, rr^viij-xxx (.50 to 2. gm.). 

Acidum Suiphurieum Dilutum (Igij to Oj). 
Dose, ntij-v (.12 to .30 gm.). 



SULPHURIC ACID. 113 

Also enters into the manufacture of Acidum S-ulphurosum, 

Aluminii Sulphas, Atropine Sulphas, Caclmii Sulphas, Ferri 
Sulphas, Hydrargyri Sulphas Flava, Liquor Ferri Subsul- 
phatis, Liquor Ferri Tersulphatis, Oleum iEthereum, Quiniae 
Sulphas, Acidum Hydrocyanicum Dilutum, JEther, Argenti 
Cyanidum, Chloroformum Purificatum, Hydrargyri Chlori- 
dum Corrosivum, Hydrargyri Chloridum Mite, Hydrargyri 
Cyanidum, Pyroxylon, Sodii Phosphas, Spiritus xEtheris 
Nitrosi, and Yeratria. 

Tests. 

If in a concentrated state, auy organic matter placed in 
contact with it is blackened and charred ; when mixed with 
an equal bulk of water, much heat is evolved; when boiled 
with copper filings or mercury, sulphurous acid gas is gene- 
rated. When the acid is in a diluted state, the best test is 
nitrate of barium, which causes a dense white precipitate of 
sulphate of barium ; this can be verified by calcining it for 
some minutes with an equal weight of charcoal, wrapped in 
platina foil, then introducing the residue into a glass tube 
and adding a few drops of muriatic acid. This will liberate 
sulphuretted hydrogen, which can be recognized by its odor, 
and by its blackening carbonate or acetate of lead. 

Poisoning. 

The symptoms are those of an acrid, corrosive poison. 
They come on suddenly after taking food or medicine, and 
the patient soon becomes collapsed. Recovery is apt to be 
followed by stricture of the oesophagus. 

Antidotes. 

Alkalies should be given in milk or soapsuds, though much 
water would be improper. Care should be taken not to rup- 
ture the stomach by the tube of the stomach-pump, or by 
inducing severe efforts at vomiting. The acid, when concen- 
trated, discolors the mouth and lips, making a black slough. 
"When administered medicinally it should be taken much di- 
luted through a glass tube, in order to protect the teeth. J 

External Use. 

Strong sulphuric acid is the most powerful caustic of this 
group, rapidly charring and desiccating the tissues, from its 

10* 



114 SULPHURIC ACID. 

great affinity for water. M. Velpeau, of Paris, strongly re 
commended its use in cancer, the acid being made into a 
paste with saffron, and applied to the morbid growth, it 
being found, after detachment of the sloughs, that a clean 
ulcerating surface remained ; and Professor Syme proposed 
a modification of this plan, on the score of economy, by using 
sawdust instead of saffron. Ricord, of Paris, also advises the 
application of sulphuric acid in combination with charcoal to 
primary syphilitic sores, holding that, if this process is 
effectually carried out before the fourth day, we may hope to 
avert the evil consequences of constitutional infection. 

Mr. Pollock has advised the local use of strong sulphuric 
acid in caries and necrosis and suppurating synovial mem- 
brane of joints, either applied on a glass rod, or injected, or 
brought into contact on lint with the diseased surfaces, in the 
proportion of one part of acid to two, three, or six parts of 
water ; and this plan of treatment lias been used with good 
success in St. George's Hospital (vide '* Lancet," May 28, 
1870, and " Medical Times and Gazette," December 11, 
1875). 

Internal Use. 

Diluted sulphuric acid is a good astringent, and as such 
is extensively used in night sweats and in diarrhoea, more 
especially that which is so common in summer. It has also 
been advised, in the form of lemonade, as a prophylactic 
against painters' colic, and there is no doubt that it heightens 
materially the action of purgative salts, probably by increas- 
ing their solubility. 

fy. Magnesii sulphatis 

Ferri sulphatis 

Acidi sulplmrici diluti 

Inf'usi calumbse q. 

Misce, fiat mistura. 
S. Capiat coehlearia magna duo omni mane. 

I£. Acidi sulplmrici diluti f 5iiss ; 10 Gm. 

Tincturse opii f 3j ; 4 " 

Syrupi aurantii f §j ; 32 " 

Aquse q. s. ad f §viij ; 256 " 

M. S. Capiat unciam imam ter in die post siugulas 
sedes liquidas. 



§ij; 


64 Gm 


gr. xxiv ; 


1 60 


t'5ij; 


8 


ad 1 gviij ; 


256 



SL'LPnUROUS ACID — TANNIC ACID. 115 



ACIDUM SULPIIUROSUM— SULPHUROUS ACID. 

[An aqueous solution of sulphurous acid gas, having the odor of burning 
sulphur, and a sulphurous, sour, and somewhat astringent taste. Its 
specijic gravity is about 1.03-3. 

Dose, f'5 ss an d f 3J (-• t0 ^' o m 0' Largely diluted with 
water.] 

External Use. 

The therapeutic properties of this acid depend in part on 
its very poisonous influence on the lowest forms of animal 
and vegetable life. Thus it forms a good application to 
those varieties of skin disease, as tinea tonsurans, chloasma, 
etc., which depend on the presence of a minute cryptogamie 
plant; and Dr. Dewar some years ago published a pamphlet 
in which he ascribed to this acid powers little short of mar- 
velous. Going on this theory that a very great number of 
diseased conditions depend on the irritation of germs, Dr. 
Dewar most confidently advised its use in affections ranging 
from rheumatic fever to chilblains. Although experience has, 
naturally, not borne out his extra vagaut assertions, we have 
to thank him for making known to us the undoubtedly good 
effect of sulphurous acid in various forms of sore throat, used 
in considerable dilution either as spray or gargle. It is also 
a good disinfectant, as we know that the antiseptic properties 
of sulphur, when burnt for purifying purposes, depend on its 
formation. 

Internal Use. 

Sulphurous acid has been recommended by Dr. Lawson in 
pyrosis, the dyspeptic symptoms attending which are due to 
various forms of leptothrix and vegetable growths burrowing 
in the mucous membrane of the stomach ; and in flatulence 
it is also deserving of a trial. 



[TANNIC ACID. 

Officinal Preparations, U. S. 

Aeidum Tannieum. Dose, gr. j-iv (.06 to .24 gm.). 
Unguentum Aeidi Tanniei (3ss to Jj). 
Glyeeritum Acidi Tanniei (3>j to ijj). 



116 TARTARIC ACID. 

Suppositoria Aeidi Tanniei, each gr. v. 

Trochisei Aeidi Tanniei, each gr. j. 

The test for tannic acid is albumen, gelatin, or the salts of 
iron ; with the first two it produces an insoluble precipitate, 
with the last a black color in solution. 

Tannin is incompatible with albumen, gelatine, the gluco- 
sides, and substances containing alkaloids, and with most 
metallic salts in common use. 

For medical uses, see Galea.] 



[ACIDUM TARTARICUM— TARTARIC ACID. 

Officinal Preparations, U. S. 

Ferri et Ammonii Tartras. Dose, gr. x-xxx (.60 
to 2. gm.). 

Pulveres Effervescentes. (Soda powders.) 
Pulveres Effervescentes Aperientes. (Seidlitz 

powders.) 

Poisoning. 

Tartaric acid is a corrosive vegetable poison; its symp- 
toms are very analogous to those caused by oxalic acid, and 
the morbid appearances likewise resemble those produced by 
oxalic acid. 

Tests. 

When heated on platina foil, it burns with a pale reddish 
flame, and exhales a peculiar acrid vapor, leaving much car- 
bonized matter. When a solution is treated with lime-water, 
it affords a white precipitate, soluble in an excess of the acid ; 
when treated with caustic potassa, it affords a granular pre- 
cipitate of the bitartrate. 

Antidotes. 

The alkalies, magnesia, lime, soap, or the alkaline car- 
bonates. 

Internal Use. 

It has been stated that tartaric acid, in .60 to 1.20 gm. (gr. 
x-xx) doses, given thrice daily will render the urine acid. 
The tartrate of magnesium has been recommended as a 
cheaper substitute for the citrate, as an aperient, and is con- 



VALERIANIC ACID. 117 

sidered quite as efficient. In sweetened solution, tartaric acid 
is sometimes used as a refrigerant drink in fevers. The- tar- 
trates are laxative and diuretic] 



[ACIDUM VALERIANICUM— VALERIANIC ACID. 

A colorless liquid, of an oily consistence, a penetrating disagreeable 
odor, and caustic taste. Its specific gravity is 0.935. U. S. 

Officinal Preparations, U. S. 

Ammonii Valerianas. Dose, gr. ij-v (.12 to .30 gm.). 
Quinia? Valerianas. Dose, gr. j-iij (.06 to .18 gm.). 
Zinci Valerianas. Dose, gr. j-ij (.06 to .12 gm.). 
Morphia Valerianate (not off.). Dose, gr. i to ^ 
(.01 to .03 gm.). 

Properties. 

Valerianic acid is an example of an organic acid made by 
synthesis, through the oxidation of amylic alcohol (fusel oil) 
by chromic acid. The valerianate of the oxide of amyl is 
used as an artificial fruit-essence, when largely diluted. 

Valerianic acid is said to resemble valerian in its effects, 
and in the form of the valerianates, may be used in nervous 
headache, neuralgia, and hysteria. The salts are best given 
dissolved in simple elixir, or in a pill.] 

[Aeida. 

List of acids, officinal in the U. S. Pharmacopoeia : — 

Acidum Aceticum Acicluni Nitricnm Dilutum 

" " Dilutum '* Nitro-Muriaticum 

" Arseniosum " " Dilutum 

" Benzoicum " Oxalicum 

" Carbolicum " Phosphoricum Dilutum 

" " Impurum " " Glaciale 

" Chromicum " Sulphur icum 

4 ' Citricum '' " Aroraaticum 

" Gallicum '.' " Dilutum 

" Hydrocyanicum Dilutum " Sulplmrosum 

" Lacticum '' Tannicum 

" Muriaticum " Tartaricum 

" " Dilutum " Valerianicum.] 

" Nitricum 



118 ACONITE. 



ACONITUM— ACONITE. 

[Aeoniti Folia. — The leaves of Aconitum Napellus, 
U. S. 

Aeoniti Radix The root of Aconitum Napellus, U. S. 

Officinal Preparations, U. S. 

Aeonitia (from the root). Crystallized and amorphous, 
or Aconitine, Pseudo-aeonitine, Napellina, Napeline, etc. 

Extractum Aeoniti (of the leaves). Dose, gr. ss 
(.03 ? m.). 

Emplastrum Aeoniti (from the root). 

Linimentum Aeoniti (from the root, gxvj to Oj). 

Tinetura Aeoniti Radieis. (|vj to Oj.) Dose, 
gtt. j-v (.06 to .30 gm.). 

{Fleming- s tincture of aconite root contains §xss to Oj.) 

Antidotes. 

Finely powdered animal charcoal, tannin, astringent in- 
fusions, and hot alcoholic stimulants, are useful. The stom- 
ach should be carefully washed out, and subsequent symp- 
toms met pro re nata.~\ 

Poisonous Properties. Therapeutical. 

Aconite may kill either by In poisoning by aconite, 

direct cardiac syncope, or, we must endeavor to sustain 

if the action be less rapid, by the flagging action of the 

respiratory failure. Great heart by giving stimulants, 

muscular weakness is noted, and keeping the patient most 

the heart's action becoming rigidly in the recumbent pos- 

feeble and irregular, the face ture, as death has occurred 

pale, the body bedewed with from syncope produced by 

clammy sweat, the pupils first suddenly sitting up in bed. 

contracted, and then dilated Digitalis has been proposed 

shortly before death closes as the physiological antidote, 

the scene. The resemblance bracing up and restoring the 

of aconite root to horse-radish contractility of the heart 

has afforded several lamenta- muscle (Fot hergill). [20 

ble opportunities of studying minims of tincture of digitalis 

cases of accidental poisoning, may be administered hypo- 

dermically.] 



ACONITE. 



119 



Local Action. 



Physiological. 

Aconite, locally applied, 
causes a sensation of tingling, 
followed by numbness of the 
skin, from a paralyzing influ- 
ence, no doubt, on the sen- 
sory nerves. It may also 
bring about some local vaso- 
motor paralysis. 



Therapeutical. 

Aconite is a most valuable 
local sedative in painful ner- 
vous affections, and more es- 
pecially in facial neuralgia, 
where the tincture or lini- 
ment, applied along the course 
of the affected nerve, will 
often allay and even remove 
suffering:. 



Constitutional Action. 
Physiological. Therapeutical. 

1. On Nervous System — . 
1. Brain — In poisoning by 
aconite, the intellectual facul- 
ties are usually quite unaffect- 
ed, but in some cases stupor 
has been observed. 

2. Spinal Cord Aconite 

paralyzes both the reflex and 
the motor activity of the cord, 
as evidenced by almost total 
loss of power in the muscular 
system. 

The respiratory centre also 
eventually becomes paral- 
yzed, and death may result 
by suffocation. 

3. Although this loss of 3. Aconite is one of our 
voluntary movement is sup- best remedies in facial neu- 
posed to be primarily spinal ralgia, given either alone or 
in origin, it is believed that 
the motor 'nerves themselves 
are secondarily affected, the 
paralyzing influence begin- 
ning at their peripheral ex- 
tremities. The inhibitory 
cardiac ganglia are first sti- 
mulated, and secondly de- 



in combination with quinine. 
In sick headache also it is of 
service, and here it will be 
prescribed along with tinc- 
ture of Indian hemp. 



120 



ACONITE. 



pressed, and a sedative effect 
is produced on the sensory 
nerves, the earliest indication 
of the action of the drug 
being tingling followed by 
numbness and amesthesia of 
the lips and throat. 

Opinions differ as to the 
influence of aconite on the 
vaso-motor nerves, and it is 
not believed by many autho- 
rities to have any special ope- 
ration over this system. Dr. 
Bagshawe, however, has pub- 
lished some cases of facial 
sympathetic paralysis, with 
injection and sweating, fol- 
lowing the local application 
of aconite, and the diaphoretic 
action, so often noted, must 
proceed from this cause. 
Experimental evidence, how- 
ever, is very conflicting in 
this, as well as in other 
points, respecting the physio- 
logical actions of aconite. 

II. Circulating Appara- 
tus. — Aconite is essentially a 
cardiac sedative, slowing the 
action of the heart at first 
from inhibitory stimulation, 
but then causing an increase 
in the rapidity of the pulsa- 
tions, with feebleness and 
irregularity, ending in death 
by arrest of all movement in 
diastole. At the same time 
the arterial pressure falls in 
very marked degree. 



II. Aconite is an excellent 
antiphlogistic, cutting short 
inflammatory processes in 
their early stages. Thus in 
pneumonia, pleurisy, peri- 
tonitis, erysipelas, rheumatic 
fever, and in the short sharp 
feverish affections of children, 
it is of signal service, and 
seems to have a directly cura- 
tive action. Dr. John Har- 
ley (Stc Thos. Hosp. Reports, 
New Series, vol. v.) made 
some interesting observations 
at the London Fever Hospital 
on the action of aconitia. 
He found that by giving ^ho 



ACONITE, 



121 



III. Respiration and Tem- 
perature. — The respiratory 
movements tend to become 
slow, finally irregular, and 
in some cases, and almost 
universally in the lower ani- 
mals, death results from ces- 
sation of breathing. 

The temperature falls de- 
cidedly. 

IV. Digestive and Secret- 
ing Apparatus. — Aconite 
has no special influence on 
digestion. It increases some- 
what the salivary secretion, 

11 



of a grain once a day, which 
was quite sufficient to produce 
physiological effects, no in- 
fluence was exerted on the 
course of 29 cases of scarlet 
fever, and that diaphoresis 
was only twice produced; 
whilst in 20 cases of typhus 
but slight controlling influ- 
ence was exerted over the 
febrile process, although the 
cases did unusually well. 
This may prove either that 
the dose was not repeated 
sufficiently often, or that 
aconite has no real power 
over fully developed inflam- 
matory processes. In coryza, 
and in acute tonsillitis, also, 
it has been much praised for 
the way in which it checks 
the full development of these 
troublesome affections, and it 
has been highly praised as 
given in 2 minim doses, 
where we have any reason to 
fear the occurrence of rigor, 
after catheterism. 

III. Some part of the good 
effect of aconite in these fe- 
brile affections must be due 
to its power in slowing the 
breathing and reducing the 
'temperature. 



IV. [It has been given in 
the vomiting of pregnancy, 
but, like most remedies for 
this disorder, with only tem- 
porary benefit.] 



122 ACONITE. 

and augments largely the 

action of the perspiratory 

apparatus of the skin, bring- Aconite is therefore an ex- 

ing out in some instances an cellent diaphoretic, and to 

irritable vesicular eruption, this action in some degree is 

The urine is also somewhat due its antipyretic properties. 

increased in quantity. 

Absorption and Mode of Elimination. 

Aconite is rapidly absorbed, and given out probably by 
the urine. The alkaloid aconitia, if accidentally blown into 
the eyes or respiratory passages, causes well-marked con- 
junctival and bronchial irritation. Prof. Gubler, of Paris, 
values it very highly in neuralgia of the 5th nerve, which he 
has never known to resist a quarter of a milligramme of the 
nitrate of aconitia, corresponding to one-half milligramme of 
the pure drug. He thinks we distrust the drug too much, 
but draws attention to a peculiar precordial disturbance, 
with palpitation and cardiac irregularity, rarely following its 
use, and warns us never to employ it in heart disease. 

Cautions and Modes of Administration. 

The very, poisonous nature of aconite renders caution 
necessary in its use, and we must prescribe it with great 
care in old persons, or where any suspicion exists of feeble- 
ness of the heart's action. In sound constitutions, however, 
and more especially in the case of children, we may use it 
with freedom, often obtaining really extraordinary results. 

It is essential to encounter the inflammation at an early 
stage, before structural changes have set in ; and it is im- 
portant to combine a little stimulant with the drug. In very 
acute cases, our best practice will be to give the tincture in 
small and very often repeated doses, carefully watching the 
effect on the pulse. One drop every ten minutes, half-hour, 
or hour, will be the best arrangement during the first day, 
after which every two hours will be a sufficient interval, the 
thermometer giving us meanwhile reliable information re- 
garding the progress of the inflammatory condition. In facial 
neuralgia* also, we shall obtain the best results by drop doses 
repeated at very short intervals, and in no case is it well to 
overstep a maximum dose of 5 minims. 



LARD. 123 

The alkaloid aconitia is occasionally used as an external 
application [in ointment, containing gr. j-ij to the ounce]. 

[It has lately been used in neuralgia, especially trigemi- 
nal, in doses of T ^ to T ^ T of a grain (.0005 Gm.). In feeble 
persons the dose to begin with should not be higher than gr. 
sho or i5o (Seguin). Murrell has lately called attention to 
the great variation of the commercial forms of aconitia, 
which, as usually supplied, is not a simple substance, but a 
mixture of several alkaloids. English aconitia is said to be 
seventeen times stronger than the German. Dangerous 
' symptoms have been reported from minute doses, and it 
seems advisable for the present to employ the tincture or ex- 
tract in preference. 

Napelline, discovered byHiibschmann in 1857, is another 
alkaloid of aconite derived from the root. Duquesnel sub- 
sequently obtained an alkaloid, which he designates nape- 
line, which is less active, and has more hypnotic and calma- 
tive properties than aconitia, and it is claimed that it pro- 
duces quiet and profound sleep in two doses of from 3 to 4 
cgr. (-J- to § grain) ; it has also been employed with advan- 
tage in neuralgia, insomnia, and excitable nervous system. 1 
(Laborde.)] 



[ADEPS— LARD. 

The prepared fat of Sus Scrofa, U. S. 

Officinal Preparations. 

Unguentum, used as a vehicle. 
Ceratum, used as a vehicle. 

Lard is emollient and is sometimes used in frictions, but 
is chiefly employed in Pharmacy in the preparation of oint- 
ments and cerates. In obstetrical and gynaecological prac- 
tice, lard is considered to be a universal lubricant, and is 
rarely absent from the lying-in chamber, where it is also used 
as a detergent to remove the vernix caseosa from the new- 
born. Washed lard is occasionally employed to prevent the 
eyelids from adhering in catarrhal conjunctivitis.] 

1 [Medical News, 1882, p. 158.] 



124 



ETHER. 



ESTHER— ETHER. 

[Used in preparing Acidum Tannicum, Ceratum Sabinae, 

Oleoresina Capsici, Oleoresina Cubeba^, Oleoresina Filicis, 
Oleoresina Lupulina?, Oleoresina Piperis, and Tinctura Opii 
Deodorata. 

Officinal Preparations, U. S. 

iEther Fortior — pure ether (for producing anaesthesia). 
Spiritus iEtheris Compositus (Hoffmann's Ano- 
dyne). iti.x-3j (-60 to 4 Gm.). 

JEther fortior is used in preparing Aconitia, Atropiae 
Sulphas, Collodium, Collodium cum Cantharide, Oleum 
JEthereurn, and Oleoresina Zingiberis.] 

Local Action. 



Physiological. 

The projection on the skin 
of a very fine spray of spe- 
cially pure ether, by means 
of Dr. Richardson's ingenious 
instrument, causes at first a 
sensation of extreme cold, 
attended occasionally by the 
formation of frost. In about 
a minute, or even less, to this 
succeeds a sudden blanching 
of the surface, the skin be- 
coming hard and quite in- 
sensible, and a sharp cutting 
pain, like a burn, being at the 
same time experienced. 

If this action is kept up for 
some time, redness, tingling, 
vesication, and even slough- 
ing may be produced. ' 

Be careful always to pro- 
cure the pure anaesthetic 
ether, which has a low boil- 
ing point, and evaporates 
rapidly, as ordinary qualities 



Therapeutical. 

Advantage has been taken 
of the insensibility to pain 
produced by the ether spray, 
to use it extensively during 
the performance of many 
minor operations, and more 
especially in those which 
consist merely of a single 
cut or prick. Under these 
conditions it acts admirably, 
but the hard and brawny 
state of the integument pro- 
duced by its action renders 
it, of little or no aid where 
dissection or manipulations 
of deep-seated structures are 
required. Further objec- 
tions to its use are the acute 
pain attending application, 
and the subsequent redness, 
tingling, and irritation of the 
skin [and possible sloughing]. 

It has also been recom- 
mended as a sedative in 



ETHER. 



125 



ot the drug are of no use for 
local anaesthesia. 



neuralgia, and as a con- 
venient means of applying 
intense cold ; and cases of 
its successful employment in 
chorea, applied to the upper 
part of the spine, have been 
recorded. 



Internal Action: 



Ether, when taken inter- 
nally, is stimulant and anti- 
spasmodic. The intoxicating 
effects rapidly produced, as 
rapidly pass away, and great 
excitement and exhilaration 
may be succeeded in an hour 
by perfect recovery. It has 
therefore been termed a dif- 
fusible stimulant. 



It is therefore a useful 
remedy in hysteria, flatu- 
lence, spasmodic asthma, 
bronchitis, dilated heart, etc. 



Combined Internal and External Use. 



Physiological. 

Ether has powerful anaes- 
thetic properties, and differs 
from chloroform in the fol- 
lowing respects : It increases 
instead of diminishing the 
arterial pressure, and acts as 
a tonic to the heart, which 
continues to pulsate in fatal 
cases after the arrest of 
breathing. The following is 

© © 

the order of involvement of 
the nerve centres : — 

1. The cerebrum. 

2. The sensory centres of 
the cord. 

3. The motor centres of 
the cord. 

4. The sensory centres ot 
the medulla oblongata. 



Therapeutical. 

The stimulant action of 
ether on the heart has caused 
its use to be warmly advo- 
cated as in all respects supe- 
rior to chloroform. It can- 
not, however, be considered 
absolutely safe, and it labors 
under several disadvantages, 

such as the greater length of 

© © 

time required to produce 
anaesthesia, the violent strug- 
gling occasionally observed, 
the disagreeable smell of the 
drug, etc. ; whilst it occa- 
sionally even happens that 
some persons cannot be fully 
brought under its influence. 
Pneumonia and bronchial 
irritation have been observed 



11* 



126 ETHER. 

5. The motor centres of by some French authorities 
the medulla. to follow its inhalation, nor 

is its safety so great as has 
sometimes been supposed, as 
13 deaths from its use have 
been recorded in England, 
and probably 5 in America 
(Cawtley Dawson, of Leeds. 
Brit. Med. Journal, March, 
1878). It is therefore doubt- 
ful whether it will ever effect- 
ually displace the more com- 
monly-used anaesthetic^ 1 ]. 

Mode of Administration. 

It is most important that no air be admitted during ether 
administration, as most violent resistance and dangerous 
struggling supervene if the vapor be not inhaled in a state 
of purity. Non-attendance to this point caused ether to 
fall into discredit soon after its original introduction, and it 
is only lately that we have been fully convinced that, by 
using this simple precaution, we may readily obtain com- 
plete anaesthesia and perfect muscular relaxation in from 
three to eight minutes. Various inhalers have been devised 
to fit tightly over the mouth and nose, and it is here essential 
that some instrument of the kind should be used. 

When operating by artificial light, do not forget the in- 
flammable nature of the vapor of ether. [The length of time 
needed to get a patient under ether is no longer a difficulty. 
Within the last four or five years the use of ether has in- 
creased rapidly in England in consequence of the adoption of 

1 [These strictures must he considered as the criticism of an 
English author upon English ether, which is declared to he of very- 
inferior quality by those who have had an opportunity of person- 
ally comparing it with the American. This will to a great extent 
explain the adherence of the English to chloroform, in spite of its 
acknowledged greater danger ; and at the same time prevents them 
from understanding the popularity of ether in the United States. 
The fact is that the washed ether (aether fortior, U. S. P.) as made 
by Dr. Squibb, Powers & Weightman, and others, is perfectly free 
from the objections just stated ; it is pure, nearly odorless, and effi- 
cient in almost the same doses as chloroform, while it is incom- 
parably safer than its rival.- — P. W.] 



ALCOHOL. 127 

better methods of administering it. Formerly the ether was 
given so abundantly as to excite choking and violent strug- 
gling. Now, methods, which produce a certain degree of 
asphyxia, by preventing the access of fresh air and allowing 
the same air to be breathed over and over again, are gene- 
rally adopted. By causing this degree of asphyxia the pa- 
tient is made to take deep and frequent respirations, which 
carry the etherized atmosphere down to the lung cells. The 
atmosphere is thus made effective without being so strong as 
to cause local irritation. The least unpleasant way of inhal- 
ing ether is to begin with laughing-gas only, and introduce 
ether vapor gradually along with gas, without allowing 

any fresh air to be admitted C] 

[For Mr. Clover's observations upon the Choice of Anaes- 
thetics see page 58.] 



iEtherea. 

JEther. Chloroform um purificatum. 

JEther fortior. Oleum aethereum. 



ALCOHOL—ALCOHOL. 

[Spirit of the specific gravity 0.835, U. S. 

Officinal Preparations, U. S. 

Alcohol Dilutum, Diluted one-half with water. 

Alcohol Fortius. Spirit of the specific gravity 0.817. 

Vinum Xerieum. Sherry wine (about 19 per cent, 
alcohol). 

Vinum Portense. Port wine (about 23 per cent, 
alcohol). 

Spiritus Vini Gallici. Brandy (about 50 per cent, 
alcohol). 

Spiritus Frumenti. Whiskey (about 50 per cent, 
alcohol). 

Spiritus Myreiae. Bay rum (for external use). 

(Spiritus Genevae, Gin, is not officinal ; the Spiritus 
Juniperi Compositus of the Pharmacopoeia may be regarded 
as its equivalent.) , 

Alcohol makes a good menstruum, and is the basis of the 
Spirits and Tinctures of the Pharmacopoeia ; the former 



128 ALCOHOL. 

being solutions of volatile substances in alcohol, the latter 
generally containing the active principles of plants obtained 
by maceration and percolation. 

Tests. 

The chemical test consists in removing the contents of the 
stomach, mixing them with distilled water, filtering, and dis- 
tilling in union with carbonate of potassium or sodium ; the 
product, is mixed with fused chloride of sodium, and again 
distilled. Alcohol, if present, will be found in the receiver.] 

Antidotes. 

The treatment of acute alcoholic poisoning must consist in 
removing all the spirit from the stomach by means of the 
stomach-pump, and endeavoring to rouse the patient from 
his perilous state of coma by cold affusion, strong coffee, 
surface stimulation, and galvanism, whilst artificial respira- 
tion may be employed to stimulate the flagging breathing 
powers. In more chronic cases, withdraw all stimulant 
absolutely and at once ; insure sleep by chloral and bromide 
of potassium; and try to diminish the morbid craving by 
capsicum, mix vomica, the mineral acids, and a liberal and 
varied diet. 

Local Actions. 

Physiological. Therapeutical. 

Alcohol has some external This hardening process has 
astringent properties from its been turned to practical ac- 
power of hardening albumen count for the prevention of 
and thus condensing the tis- bedsores, and alcohol is also 
sues, whilst, from its rapid a usual ingredient in the now 
evaporation, it produces a somewhat old-fashioned spirit 
cooling effect. [By its con- or evaporating lotions. [Al- 
stringing effects upon the cohol has been used with 
smaller vessels and nerves, great success by Ollive (La 
it checks active congestion, France Medicale, No. 28, 
reduces inflammatory action, 1882) as a topical application 
and relieves pain.] for acute inflammation of cel- 

lular tissue. Pure concen- 
trated (80° or 90°) alcohol 
is applied on compresses of 



ALCOHOL. 



129 



cotton wadding, and fre- 
quently renewed. There is 
marked relief of pain, and 
the inflammation is decidedly 
retarded or aborted. 1 ] 



Internal Actions and Uses. 



1. On Brain and Nervous 

System Alcohol primarily 

stimulates the cerebral cen- 
tres by dilating their arte- 
ries, and so admitting more 
blood ; secondly, excitement 
supervenes with impaired 
muscular co-ordination, and 
finally coma, which may 
prove fatal if the dose taken 
be sufficiently large. Whilst 
it may also in small doses 
stimulate the spinal cord, in 
larger quantities it undoubt- 
edly weakens the functions 
of that structure, causing in- 
disposition for active exer- 
tion, as well as actual want 
of power. This has been 
proved by the experience of 
campaigns, but more espe- 
cially that in Ashantee, where 
it was found that alcohol dis- 
tinctly diminished the power 
of bearing fatigue, and also 
by the experiments of Parkes, 
which showed most conclu- 
sively that 2 or 3 ounce doses 
of spirit given several times 
per diem to a couple of 
healthy men engaged in la- 
borious work, caused a slight 
primary increase of energy, 



1. A moderate quantity of 
alcohol stimulates the mental 
faculties, whilst larger doses 
become narcotic and even 
anaesthetic. In chronic nerve 
debility, as neuralgia, we 
may often relieve pain by the 
use of stimulants; but these 
are precisely the class of cases 
in which habits of intemper- 
ance are most readily formed. 
Nothing seems better 
proved than the fact that 
alcohol lessens the capacity 
for active muscular exertion, 
and it is therefore well to 
advise sportsmen, soldiers, 
and others who are about to 
undergo severe bodily fatigue, 
to reserve all stimulant until 
their day's work is over, 
when it may be of real ser- 
vice. In the Ashantee cam- 
paign a ration of rum on 
reaching camp at night 
seemed to revive the men 
after their exposure and la- 
bors. 

In those cases of chronic 
alcoholic poisoning described 
by AYilks, we must follow his 
advice, and entirely cut off 
all supplies of strong drink. 



[Pliila. Med. Times, 1882, p. 459.] 



130 



ALCOHOL. 



but a secondary well-marked 
indisposition for muscular ex- 
ertion, with actual diminution 
of bodily vigor. Dr. Wilks 
has also drawn attention to a 
remarkable series of cases in 
which paraplegia, and numb- 
ness, anaesthesia, and violent 
shooting pains, have been 
caused by the excessive and 
long-continued use of alcohol. 
On the sympathetic sys- 
tem, the effects are somewhat 
varied; for although the dila- 
tation of certain vascular 
areas must depend on para- 
lysis of these nerves, there 
seems no doubt that, as Binz 
has shown, alcohol in inflam- 
matory conditions stimulates 
the sympathetic, contracts 
the arterioles, and prevents 
that migration of the white 
corpuscles which constitutes 
the essence of this morbid 
process. The chronic abuse 
of alcohol causes nervous 
tremors and debility, gradu- 
ally leading up to that semi- 
maniacal state known as de- 
lirium tremens, in which the 
victim is haunted by the con- 
stant presence of spectral 
illusions, preventing sleep, 
and finally wearing him out 
if unchecked. The brain, 
like most of the internal or- 
gans of the body, suffers in 
alcoholism from the contrac- 
tion of new areolar tissue 
pressing upon and obliterating 
some of the nervous elements. 



This is, no doubt, one ex- 
planation of the beneficial 
action of alcohol in some 
cases of acute inflammation. 



ALCOHOL. 



131 



2. On Heart and Circula- 
tion Alcohol in moderate 

doses lias a stimulating in- 
fluence on the heart, and 
dilatation of the peripheral 
vessels and of those of the 
brain is produced. 

In chronic alcoholism we 
find a degenerated condition 
of the larger vessels, known 
as atheroma 



3. Respiration and Tem- 
perature The old observa- 
tions of Liebig seemed to 
show that alcohol was a respi- 
ratory -food, and was largely 
burnt off in the lungs, thus 
aiding in the production of 
animal heat. It is now 
found, however, that under 



2. To its action on the cir- 
culation, however, we must 
ascribe a good deal of the 
beneficial influence of alcohol 
in the treatment of disease. 
When the powers of life show 
signs of failing, when the first 
sound of the heart grows 
weak, the pulse feeble, com- 
pressible, and irregular, when 
syncope threatens, and deli- 
rium is beginning, the indi- 
cations for the administration 
of alcohol are complete, and 
it will be found to act well 
when the tongue moistens, 
the pulse gains in volume and 
regularity, sound refreshing 
sleep is obtained, and the 
temperature falls. It is, of 
course, difficult to lay down 
exact rules as to the precise 
stage of fevers at which we 
may best prescribe alcohol, 
but ordinarily we should do 
so in typhus about the seventh 
day, in typhoid the twelfth, 
in smallpox when the secon- 
dary fever is developed, and 
in acute inflammations, gen- 
erally, when the heart begins 
to fail, and the nervous sys- 
tem to show indications of 
debility. 

3. This lowering of tem- 
perature must also be ex- 
plained by diminished tissue 
metamorphosis, and by a par- 
tial arrest of the oxygen - 
bearing function of the red 
corpuscles of the blood. It 
is therefore evident that we 
must warn persons about to 



132 



ALCOHOL. 



its use the carbonic acid given 
off from the lungs is dimin- 
ished, and that the body heat 
is lowered. The carbonic 
acid, however, is probably 
only apparently diminished, 
because it is retained in the 
blood. When but small 
doses are taken, only a slight 
cooling effect is produced, 
whilst large quantities may 
reduce the temperature by 
two or three degrees, the ex- 
planation being partly that 
the dilatation of the cutaneous 
vessels enables more blood to 
be removed from the heat- 
producing centres, spread out 
and cooled in the wide sheet 
of the superficial circulation, 
and then returned, to abstract 
more warmth from the inter- 
nal organs. Another curious 
fact is that alcohol also dimin- 
ishes the power of resistance 
to cold ; and this has been 
proved not only by the expe- 
rience of Arctic voyagers, but 
by the following experiment : 
If we place two animals, one 
of which has been dosed with 
alcohol, in a chamber of which 
the temperature has been re- 
duced to 10° below freezing 
point, both will speedily be 
benumbed to sleep ; but whilst 
the healthy animal will be 
supported by the combustion 
of its tissues and survive the 
shock, its companion will 
perish from this heat-pro- 
ducing process being inter- 
fered with by the spirit. 



be exposed to severe cold of 
the fallacious nature of the 
old notion that alcohol fur- 
nishes true warmth. Post- 
mortem temperature is also 
lowered by alcohol, thus prov- 
ing that part of this action is 
due to a chemical process, 
causing a paralyzing influence 
on the protoplasm of the heat- 
producing cells. To produce 
an antipyretic effect, an adult 
will require at least two 
ounces of absolute alcohol. 

There can, however, be no 
doubt that we may often alle- 
viate the evil effects of a chill 
by a, dose of spirit [especially 
in the form of a hot toddy], 
which releases the capillaries 
of the skin from their state 
of morbid contraction, stimu- 
lates the circulation by whip- 
ping up the heart, and thus 
prevents congestion of inter- 
nal organs. 



ALCOHOL. 



133 



4. Intestinal Tract In 

small doses, alcohol stimu- 
lates the appetite and in- 
creases the supply of gastric 
juice ; but if given in larger 
quantities, this secretion is 
checked, nausea is produced, 
and the desire for food dis- 
appears. In the advanced 
stages of chronic alcoholism, 
the stomach is injured by the 
contraction of the new areolar 
tissue obliterating its glands, 
and hence we find dyspepsia 
with morning vomiting a 
very common symptom in 
drunkards. 

5. Secreting Organs 

Alcohol stimulates the liver, 
and this organ is one of the 
first to suffer from chronic 
abuse of stimulant, the areolar 
tissues being irritated, and 
an increased formation taking 
place, which gives a primary 
enlargement to the organ. 
These newly formed struc- 
tures, however, having the 
tendency to shrink or con- 
tract, gradually obliterate the 
true secreting elements of the 
gland, which grows smaller 
and harder, ascites eventually 
following from pressure on 
the portal vein and obstructed 
return of blood from the ab- 
dominal circulation. 

Kidneys — Alcohol has no 
specially well-marked effect 
on the urinary secretion, but 
the kidneys may also suffer 
from the cirrhotic degenera- 
tion just described. 
12 



Alcohol is thus often bene- 
ficial in the case of weakly 
persons, and more especially 
at the extremes of life, by 
giving tone to the digestive 
organs and aiding the due 
assimilation of food. Al- 
though its use is by no means 
essential to the healthy, it is 
of great service to dwellers 
in large towns, and others 
whose mode of life involves 
much mental strain. [Spirits 
should never be taken into 
an empty stomach, but should 
be accompanied by food.] 

Binz values alcohol as a 
food in fevers, not as actually 
building up the tissues di- 
rectly, but as an easily burn- 
ing fuel, from whose combus- 
tion, in oft-repeated small 
doses, the heat required to 
generate vital force may be 
derived, sparing the reserve 
of fat in the body and pro- 
ducing force. 

Frankland puts down the 
force-producing power of al- 
cohol as 7 to coal 8. [But 
we must not overlook the fact 
that the power of the system 
to develop and utilize this fuel 
is very limited.] 



lo4 ALCOHOL. 



Mode of Elimination. 



Alcohol very rapidly enters the blood, and is rapidly given 
out, in small part at least, by the breath, but it probably 
" undergoes combustion to a great degree in the body, main- 
tains or increases the body weight, and prolongs life on an 
insufficient diet. It is therefore entitled to be reckoned as a 
food" (Brunton). Much discussion has been expended on its 
elimination or combustion, and some years ago the hopes of 
temperance agitators were much raised by the apparent re- 
sult of experiments put forward by two French observers, 
which seemed to. prove that all the ingested alcohol is given 
out unchanged in the urinary secretion. Anstie and Dupre, 
however, showed the fallacy of this by pointing out that even 
the urine of the most rigid abstainers. contains a substance 
which cannot, by the chromic acid test, be distinguished 
from alcohol, and it has since been asserted that this may 
actually be alcohol derived from converted liver sugar. 

A good deal of uncertainty still prevails regarding the ulti- 
mate destination of alcohol. Some authorities believe that 
it is first converted in the blood into aldehyde, then acetic 
acid, and finally carbonic acid and water. Wanklyn holds 
that it may be converted in part, at least, into glycol ; but 
Binz tells us that no secondary product has ever been found, 
and that it is directly oxidized into carbonic acid and water, 
being completely destroyed in the animal organism, more 
than three per cent, being never found in the urine, under 
the most favorable conditions. 

As regards the dose of alcohol, it is manifestly impossible 
to lay down any hard-and-fast rules, as we must of necessity 
be guided by the constitution of the patient and the symp- 
toms of his special case. As a rule we may say that about 
8 oz. of brandy may be sufficient in typhus or any acute ill- 
ness, and that 16 oz. may be looked upon as the quantity 
which it is well not to exceed. In a state of health, 2 oz. 
of absolute alcohol per diem is usually considered a maxi- 
mum allowance. But we must always remember the golden 
maxim, never to permit stimulants to enter the stomach save 
in combination with food. 

It is of some importance to consider the forms of alcohol 
best adapted for varying cases, and we may say, generally, 
that champagne acts well in sudden and rapid sinking, whilst 
good whiskey or brandy may be recommended in ordinary 



ALCOHOL. 135 

acute illness. Port and Madeira are well suited for cases of 
debility; and in convalescence from acute illness and diges- 
tive feebleness, malt liquors and Burgundy will often be 
found to be of great service ; but we must always beware of 
the possibility of leading our patients into disastrous habits 
of self-indulgence by a lack of precision in our directions as 
to quantity. The actual amount to be taken at each dose, 
and the proper periods of administration, must be carefully 
written down, remembering that under these circumstances 
we must look upon the alcohol as a drug. In fact, some 
authorities go so far as to recommend that we should invari- 
ably use spirits of wine, to be prescribed in regular form ; 
but this is manifestly injudicious, as it is not only the crude 
spirit, which is an active agent, but the sugar, ethers, and 
other ingredients, more especially of old wine, are of real 
value from a therapeutical point of view. 

AVe are bound, so far as may be, to insure all possible 
purity, and more especially to avoid the adulteration with 
fusel oil, as this admixture causes very heavy intoxication, 
with disagreeable headache and other after-effects. Another 
injurious form of adulteration has been pointed out by Dr. 
Crichton Browne, and that is picrotoxine, which, added, as 
it often is, to beer, produces epileptiform seizures. 

The following are the relative proportions of absolute alco- 
hol in the liquors most commonly in use: — 

Brandy, gin, whiskey . . . . 30 to 50 per cent. 

Sweet Spanish and Italian wines . . 13 to 17 " 

Hook and cbiret 8 to 11 " 

Edinburgh ale ...... 6 " 

Bavarian beer . . . . . 4 to 5 " 

Stout 4 " 

[Spiritus .ZEtheris Compositus is an alcoholic solu- 
tion of ether, impregnated with oil of wine, and is popularly 
known as Hoffmann's anodyne liquor. It is used in hysteria 
and nervousness. Dose, r^x to f'3j (-60 to 4. 6m.)] 

[By the action of sulphuric and nitric acids upon stronger 
alcohol, nitrous ether is produced, which, in combination 
with alcohol, is called spirit of nitrous ether, or, commonly, 
sweet spirits of nitre.] 

Spiritus -ffitheris Nitrosi. This preparation, in 
doses of from 2. to 8. grammes (from 1 rl. drachm to 2 fi. 



136 AMYLIC ALCOHOL — GARLIC. 

drachms), is diuretic and diaphoretic, and is much used in 
feverish conditions. 



[ALCOHOL AMYLICUM— AMYLIC ALCOHOL. 

Syn. Fusel Oil. 

A peculiar alcohol obtained from fermented grain or 
potatoes by continuing the process of distillation after the 
ordinary spirit has ceased to come over. U. S. 

Amy lie alcohol is an active irritant poison, for which no 
direct antidote is known. 

Officinal Preparations, U. S. 
Ammonii Valerianas and Quinia^ Valerianas. 

In addition to valerianic acid and its salts, amylic alcohol 
is used in the manufacture of the non-officinal nitrite of amyl, 
which has become of sufficient interest to warrant extended 
notice. It has come into general use, although not yet ac- 
cepted by the Pharmacopoeia, and will be found among the 
new remedies at the end of this section. 

The valerianates are used for the same purpose (hysteria 
and nervousness) for which valerian formerly was given. 

For discussion of effects, see Valerian.] 



[ALLIUM— GARLIC. 

The bulb of Allium sativum, U. S. 
Dose of the fresh bulbs, 3j— \j (^ to 8 Gm.). 

Officinal Preparation, U. S. 

Syrupus Allii. Dose, f3j, or for an infant n^ v-x (.30 
to 4. Gm.). 

Garlic is a stimulating expectorant, and is used with good 
effect in the later stages of catarrhal bronchitis, or suffocative 
catarrh in young children, in which cases it may also be used 
as a poultice to the chest. These poultices, composed of the 
freshly boiled bulbs pounded into a mass, used either alone 
or with an equal quantity of linseed meal, may also be used 



ALOES. 137 

in infantile convulsions, applied to the back and legs, or the 
oil of garlic may be used as a rubefacient. 

The following would be an appropriate formula for the 
catarrhal bronchitis of infants : — 

$. Syr. allii f|j ; or 32 Gm. 

" ipecacuanha? 1 3iij > " 12 " 

" tolutani i^v ; " 20 " 

" acacia? f^vj ; " 24 " 

Tinct. opii campliorat. q. s. ad fjiij ; " 96, " M. 

S. Dose, tt^xx to i'3J.] 



ALOE— ALOES. - 

[Aloe Barbadensis, Barbadoes Aloes. The inspis- 
sated juice of the leaves of Aloe vulgaris, U. S. 

Aloe Capensis, Cape Aloes. The inspissated juice of 
the leaves of Aloe spicata, and of other species of Aloe. 

Aloe Soeotrina, Socotrine Aloes. The inspissated 
juice of the leaves of Aloe soeotrina. 

Officinal Preparations, U. S. 

Aloe Purificata, purified aloes. Dose, gr. v-x (.00 
to .GO Gm.). 

Pilula^ Aloes. (Aloes and soap, aa 1 part.) 2 grs. 
of aloes in each pill. 

Pilula^ Aloes et Assafoetida^. (Aloes, assafoetida, 
and soap, aa 1 part.) l-j\ grs. aloes in each pill, 

Pilula3 Aloes et Mastiches. (Aloes 4 parts, mastic 
and rose leaves, aa 1 part.) 2 grs. in each pill. 

Pilule Aloes et Myrrh®. (Purified Aloes, 4 parts, 
myrrh and aromatic powder, aa 1 part.) 2 grs. in each pill. 

Pilule Rhei Composite. (Each Aloes gr.jss, rhu- 
barb gr. ij.) 

Pulvis Aloes et CaneLLge. (Aloes, 4 parts, canella 
1 part.) 

Tinetura Aloes. (5ss to Oj.) Dose, f5j-"j (L to 
12. Gm.). 

Tinetura Aloes et Myrrh®, (aa gjss in Oj.) Dose, 
f3j-y (4. to 8. Gm.). 

Tinetura Benzoini Composita. Dose, rr^x-xxx 
(.00 to 2. Gm.). 

12* 



138 



ALOES. 



Vinum Aloes (Aloes, c 
wine). Dose, f^j (4 Gm.). 
Suppositoria Aloes. 

fied aloes.] 

Physiological Action. 

Aloes acts on the lower 
part of the large intestine, 
stimulating its peristaltic 
movements, and causing the 
evacuation of formed and only 
slightly softened feces. It 
also increases the secretion of 
bile, and some authorities 
hold that its purgative action 
is merely secondary to this. 
A good deal of congestion 
about the rectum is produced, 
and a sympathetically stimu- 
lating effect may extend to 
the uterus, and tend to excite 
its functions. 

The recent experiments of 
Rutherford have shown aloes 
to be possessed of undoubted 
cholagogue properties. 

[The active principle is 
termed Aloix, which is some- 
times used instead of aloes in 
from one-half to one-third of 
the dose. " Its cathartic ac- 
tion is said to be uniform, 
rather more speedy than that 
of crude aloes, and unattended 
by griping." 1 ] 



irdamom, and ginger, in sherry 
Each containing gr. ij of puri- 

Therapeutical Action. 

Aloes is a very certain, ef- 
ficient, and mild purgative 
[in doses of ten to twenty 
grains], acting, however, 
• rather slowly, and seldom 
producing its effects before 
from six to twelve hours. 

It occasionally, however, 
gripes, and is, therefore, 
usual given in combination 
with other remedies which 
diminish this tendency, and, 
from its action on the lower 
bowel, it must be avoided in 
any local inflammatory con- 
dition, or in the acuter forms 
of haemorrhoids. 

Its mild and slow action 
has caused it to be much used 
in dyspepsia ; it forms a prin- 
cipal constituent of most din- 
ner pills ; and it is also a 
popular remedy in habitual 
constipation. It has also em- 
menagogue properties de- 
pending partly, no doubt, on 
the sympathy of contiguity. 
In the form of pill or de- 
coction, and given, as laid 
down by Graves, at the time 
when the catamenia are natu- 
rally expected, it often proves 
most efficient. [The purified 
aloes should be used, as the 
commercial aloes contains im- 
purities.] 



The National "Dispensatory, Phila., 1879, p. 137. 



JVIARSHMALLOW — ALUM. 139 



Dose, etc. 

The most useful preparations of aloes are, the compound 
decoction, dose, fjfj to f^ij ;* the pil. aloes et myrrhse; and 
aloes and iron. 

[For chronic constipation : — 

I£. Ext. belladonna? gr. ^ ; or 01 Grin. 

" colocynth. comp. 

Aloes, aa gr. jss ; " 09 " 

01. anisi I^j; " (06 " M. 

Ft. pilula et mitte tales No. xij. 

S. Dose, two or three at bedtime. 

For chronic constipation, in women with uterine dis- 
order : — 

B- Aloes purificat. gr. ij ; or 12 Gm. 

Ferri su.lph.at. 
Terebinth, alb., aa gr. j ; " ,06 " M. 

Ft. pil. sec. art. 

S. Dose, one or two pills per diem. 

Suppositories of aloes are used against ascarides.] 
[ALTH^A— MARSHMALLOW. 

The root of Althcea officinalis, U. S. 

Marshmallow is a demulcent, as it contains chiefly muci- 
lage and starch. It is occasionally exhibited as a decoction 
in fevers, or inflammation of mucous membranes. In the 
form of a confection it is popular as a pectoral.] 



ALUMEN— ALUM. 

[Aluminii et Ammonii Sulphas, U. S. 

Dose, gr. x to xx (.60 to 1.30 Gm.), or, as a purgative, gr. 
v to 5j (.'30 to .4 Gm.). 

Alumen Exsiecatum. Dried alum.] 

Local Action. 

Pliysiological. Therapeutical. 

Alum, used externally, It is, therefore, much em- 

tends, like most astringents, ployed as an astringent lotion 

1 [This is a favorite preparation of the British Pharmacopoeia. 
It contains aloes, licorice, carbonate of potassa. myrrh, saffron, and 
tincture of cardamom, and is gently cathartic] 



140 



ALUM. 



to contract the bloodvessels 
and condense the tissues by 
coagulation of their albumen. 



in conjunctivitis, leucorrhcea, 

gonorrhoea, and as a gargle 
in sore throat. [Dried alum 
is a mild escharotic for exu- 
berant granulations, etc.] 



Internal Actions and Uses. 



1. On Nervous System. — 
Alum seems to have some 
power in relieving spasmodic 
action. 



1. It is, therefore, benefi- 
cial in some cases of ivhoop- 
ing-cough, and in colica pic- 
ton inn. [In whooping-cough 
it is given in small doses of 
gr. j-ij (.06 to .12 Gm.), in 
syrup and water several times 
daily. It is also one of the 
best direct emetics in croup. 
Dose, 3ss (2. Gm.), repeated 
every half hour if necessary.] 

2. Alum has been used for 
internal hemorrhage, and to 
check excessive sweating, and 
its action in whooping-cough 
is also largely due to its astrin- 
gent properties, as it is most 
useful in the later stages, 
when profuse secretion has 
been established. 

3. This also explains its 
use in colica pi do num. 



2. Circulation. — This, no 
doubt, is intimately connect- 
ed with No. 1, as the con- 
traction of the bloodvessels 
and internally astringent ef- 
fects which follow the use of 
alum are probably dependent 
on nervous influence. 

3. On Secretion. — Alum 
occasionally acts both as an 
emetic and a purgative. 

Use, 
In lotion, gr. ij ad x, or : — 
F£. Alunainis 
Aquae rosse 

Lotion in catarrhal ophthalmia. 

I£. Aluminis 

Acidi sulpliurici dil. 
Syrupi liiaonis 
Aquae 
S. Capiat cochleare magnum secuuda quaque hora. 

In colica pidonum. 

[Dried alum may be given in pill, gr. ij (.12 Gm.), in 
hcemoptysis.~] 



gr. x; 


or 


|60 Gir 


i. 


f§iv ; 


i ( 


1281 


M. 


5iJ ; 


or 


8! Gm. 




m ; 


it 


4| " 




m ; 


a 


32| " 




f Jiij ; 


a 


96| " 


M. 



ALUMINII SULPHAS — AMMONIA. 141 

[ALUMINII ET POTASSII SULPHAS. 

Potassa-Alum, U. S.~\ 



[ALUMINII SULPHAS. 

Sulphate of Aluminium, U. S. 

The potassa-alum has the same medical properties as the 
officinal alum, just considered, and, in fact, was the Alumen 
of the Pharmacopoeia in the edition of 1860. 

The sulphate of aluminium is antiseptic and astringent. 
It is sometimes employed as an injection in gonorrhoea and 
leucorrhoea. It has also been used to fill carious teeth, and 
in solution is employed to inject and preserve subjects for 
dissection.] 



[AMMONIACUM— AMMONIAC. 

A gum-resinous exudation from Dorema Ammoniacum, U. S. 
Officinal Preparations, U. S. 

Mistura Ammoniaci. Dose, f|ss (1G. Gm.). 
Pilulae Seillse Composite. Dose, pills j-ij. 
Emplastmm Ammoniaci. 
Emplastrum Ammoniacum cum Hydrargyro. 

Internal Effects. 

Ammoniac may be used in chronic bronchitis with defec- 
tive secretion, but its systemic influence is not very evident. 
It is given in substance (dose gr. x-xxx) or rubbed up with 
water so as to form the Mistura Ammoniaci, or milk of am- 
moniac. The pills (each containing squills gr. ss, ginger 
and ammoniac, aa gr. ij with soap) are expectorant and 
stimulating. The plasters are resolvent and mildly counter- 
irritant, being useful in enlarged joints and scrofulous tumors.] 



AMMONIA— AMMONIA. 

[Officinal Preparations, U. S. 

Aqua Ammoniae Fortior. (About 26 per cent, of 
Ammonia.) 



142 AMMONTA. 

Aqua Ammonise. (About ten per cent, of Ammonia.) 

Iiinimentum Ammoniae. (Aq. Ammon. ^, oil §.) 

Liquor Ammonii Aeetatis. Dose, f gss-j (16. to 
32. Gin.). 

Spiritus Ammoniae. Dose, m u x-xv (.GO to 1. Gm.). 

Spiritus Ammonias Aromaticus. Dose, f3ss-j (2. 
to 4. Gm.). 

Tinetura G-uaiaei Ammoniata. Dose, f"3j (4. 
Gm.). 

Tinetura Valerianae Ammoniata. Dose, f^j-ij 
(4. to 8. Gm.). 

Alumen. Dose. gr. j-ij, or gr. x-5ij, as an emetic. 

Ammonii Benzoas. Dose, gr. x-xx (.00 to 1.30 Gm.). 

Ammonii Bromidum. Dose,gr.x-xv(.60 to 1.6m.). 

Ammonii Carbonas. Dose, gr. x (.GO Gm.), as an 
emetic gr. xxx (2 Gm.). 

Ammonii Chloridum. Dose, gr. v-xx (.30 to 1.30 
Gm.). 

Ammonii Chloridum Purifieatum. Dose, gr. v- 
xx (.30 to 1.30 Gm.). 

Ammonii Iodidum. Dose, gr. v-x (.30 to 1.30 Gm.). 

Ammonii Nitras (used in making Nitrous Oxide). 

Ammonii Sulphas (used in making Ammonio-ferric 
Alum). 

Ammonii Valerianas. Dose, gr. ij-v (.12 to .30 
Gm.). 

Cuprum Ammoniatum. Dose, gr. \-± (.01 to .03 
Gm.). 

Ferri et Ammonii Citras. Dose, gr. v-x (.30 to 
.60 Gm.). 

Ferri et Ammonii Sulphas. Dose, gr. iij-x (.18 
to .60 Gm.). 

Ferri et Ammonii Tartras. Dose, gr. x-xxx (.60 
to 2. Gm.). 

Hydrargyrum Ammoniatum, used in ointment.] 

Poisoning. 

If given in large quantities, ammonia may cause death by 
inflammation of the stomach and intestines ; and, according 
to Richardson, it may also kill by dissolving the red cor- 
puscles of the blood. 



AMMONIA. 



143 



[Antidotes. 

Vegetable acids and demulcents. The fixed oils may be 
administered, and the usual after-treatment instituted for 
poisoning by the caustic alkalies.] 

Local Action. 



Physiological. 

The stronger preparations 
of ammonia are irritating to 
the skin, causing redness and 
speedy vesication on account 
of their power of dissolving 
the cuticle. 



Chloride of ammonium, on 
the other hand, is rather 
soothing, and cools the skin 
by aiding the speedy evapo- 
ration of fluids. 

The vapor of ammonia is 
stimulant and irritating. 



Therapeutical. 

Ammonia is, therefore, a 
component part of many stim- 
ulating liniments, and is an 
excellent counter-irritant and 
vesicant. It is a good ap- 
plication to the sting of in- 
sects or the bite of poisonous 
snakes. 

Chloride of ammonium 
used to be an invariable in- 
gredient in evaporating lo- 
tions. 

Ammonia is used by inha- 
lation in syncope, and as an 
aid in the restoration of per- 
sons poisoned by prussic acid ; 
but care must be taken not 
to allow its vapor to enter 
the air-passages too freely 
during unconsciousness, or 
serious inflammation may be 
produced. 



Constitutional Actions and Uses. 



I. On Brain and Nervous 

System The preparations 

of ammonia, generally speak- 
ing, are stimulant in their 
action, affecting, however, 
rather the ganglionic and 
spinal systems than the brain 



I. Ammonia in its various 
preparations is very largely 
used as a stimulant in many 
cases of exhaustion and de- 
bility. It is the best means 
of combating the depressing 
influence of snake-bite ; it is 



144 



AMMONIA. 



proper, and thus 
from alcohol. 



differing 



Chloride of ammonium 
has, according to Anstie, the 

property of giving increased 
tone to sensory nerves. 



II. Circulation and Respi- 
r at ion. — Ammonia increases 
the force and frequency of 
the heart's action, this ex- 
plaining some part of its 
stimulating influence. It 
may also aid the respiratory 
power by giving tone to the 
muscular fibres surrounding 
the bronchial tubes, and 
simulating the respiratory 
centre. 

AY hen injected into the 
blood, ammonia has the 
power of dissolving the red 
blood corpuscles [possibly, to 
a moderate extent. But the 
chief source of danger after 
intra-venous injection lies in 
its power of interfering with 
the function of the blood-cell 
as an oxygen-carrier. In 



in valuable mbronchitis, pneu- 
monia, and all typhoid condi- 
tions, being more diffusible 
and less stupefying than alco- 
hol ; whilst in prussic-acid 
poisoning it may be admin- 
istered internally as well as 
externally. 

Chloride of ammonium is 
very serviceable in many 
cases of neuralgia, and in 
those wearing muscular [tains 
in hard-worked women and 
others usually described un- 
der the term myalgia. [Am- 
monium bromide has been 
highly recommended in acute 
rheumatism in doses of gr. 
xx-xxx, three or four times 
daily.] 

II. It is therefore a very 
generally used stimulant in 
acute disease. 



It has therefore been used 
with success by Richardson 
in those cases where, as after 
delivery, diphtheria, ovari- 
otomy, etc., a clot is forming 
in the heart, and he recom- 
mends it by injection into 
the veins, stopping short of 
solution of the red corpuscles. 



AMMONIA. 



145 



cases of fatal ammonia poison- 
ing the blood, after death, is 
found to be dark and to con- 
tain very little oxygen, nor 
will it absorb the gas and 
become arterialized when agi- 
tated in an atmosphere of 
pure oxygen. The red blood- 
corpuscle is also found to be 
altered and to show unusual 
resistance to the action of 
acetic acid.] And it is also 
supposed to diminish the 
coagulating property of the 
blood and to assist in the 
solution of fibrinous concre- 
tions already formed. 

III. On Secretion — Un- 
der this head it may be con- 
venient to place — 

1. The emetic action which 
is specially developed by 
large doses of carbonate of 
ammonia. This effect is also 
produced by injection into 
the blood. 

2. Ammonia increases the 
secretion from the bronchial 
mucous membrane. 



3. Intestinal Ammonia 

in large doses increases the 1 
secretion from the intestines, 
and may cause diarrhoea, and 
it also neutralizes acid secre- 
tions. 

4. Cutaneous Ammonia, 

more especially in the form 

13 



1. Carbonate of ammonia 
is used as an emetic to assist 
in clearing the air-passages 
from accumulated mucus, and 
in some cases of poisoning. 

2. This, in addition to the 
stimulant action, explains 
the great power of ammonia 
over bronchitis in the weak, 
young, or aged, and the later 
stages of pneumonia., where 
it promotes expectoration by 
thinning and rendering the 
sputa less tenacious. 

3. It is never used as a 
purgative; but this irritating 
action on the bowels may 
render it an undesirable form 
of stimulant in enteric fever. 
It is a useful antacid. 

4. Liquor ammonii ace- 
tatis is one of our best dia- 



146 AMMONIA. 

of liquor ammonii acetatis, phoretics in a great variety 
acts freely on the skin. of feverish conditions. 

o. Urinary — No special 
action. 

Finally, ammonia has been employed under various condi- 
tions which cannot conveniently be grouped under any precise 
physiological heading ; but these we will consider when we 
refer seriatim to the various preparations of the drug. 

Mode of Elimination. 

Ammonia is very rapidly given out from the system, 
principally by the urine, but also in lesser degree by the 
breath and sweat. 

Preparations. 

Liquor ammonias fortior [Br.] and liquor ammonias [Br.]. 
These are seldom used internally, but occasionally as men- 
tioned above, by vapor and injection. Dr. Halford, of Aus- 
tralia, has also proposed the employment of ammonia in this 
way to neutralize the poison of snake-bites ; but, unfortu- 
nately, wider experience has not confirmed the promise of his 
earlier researches. Dose by injection, from 10 to 20 minims. 

Ammonii carbonas. This is the most active and efficient 
preparation, used as a stimulant in doses of from 3 to 10 
grs., as emetic 30 grs. Some authors have looked upon 
ammonii carbonas as a specific for scarlet fever, but of the 
soundness of this view no sufficient evidence has been pro- 
duced. It is nauseous and pungent, and must be well dis- 
guised, milk being a good vehicle. 1 

R. Ammonii carbonatis gr. xl ; or 2 50 Cm. 

Tincturse scillse 

Syrupi tolutani 

Decocti senegse 
Misce, fiat mistura. 
S. Capiat unciam unam qnarta quaque hora. 

Stimulating expectorant. 

Spiritus ammonias aromaticus contains nutmeg, lemon, and 
spirit in addition to the ammonia. [This is an agreeable pre- 
paration either for inhalation or internal administration.] 

1 [Carbonate of ammonia must not be prescribed in combination 
with syrup of squill or syrup of garlic, as they contain acetic acid.] 



gr. xl ; 


or 2 


fsffl ; 


8 


f 3iij ; 


" 12 


f ivij ; 


" 224 



ALMOND. 147 

Ammonii chloridum. Used as a tonic in neuralgia, in 
doses of from 20 to 30 grs. ; but it is very nauseous, resem- 
bling sea-water in flavor. [It is also a common addition to 
expectorant cough mixtures.] 

Gm. 



I£. Ammonii cliloridi 


- aft; 


or 


8 


Ext. glycyrrhizse 


|ss ; 


" 


16 


Syrupi tolutani 


fij ; 


a 


32 


Aq. cinnamomi 


ad f§viij ; 


" 


25 6 



M. 

S. Capiat unciam unam quartis lioris. 

In neuralgia, or bronchitis. 

It has also, but with little real foundation, been supposed 
to possess some power of aiding the absorption of lymphatic 
and glandular enlargements, and has been regarded as a good 
remedy in chronic liver disease. 

Ammonii bromidum seems to have an occasional and un- 
certain influence over whooping-cough, and is thought by 
some to be a good substitute for bromide of potassium in 
epilepsy and other nervous disorders. 

Liquor ammonii acetatis and liquor ammonii citratis [Br.] 
are diaphoretic in doses of from I' 3 i j to f'Jj (8 to 32 Gm.). 



I£. Liq. am. acetatis f% ij ; or 64 

Syrupi limonis f ,^j ; " 32 

Sp. aetheris nitrosi f^iij ; " 12 

Infusi serpentariae ad f § v T iij ; '•' 256 

S. Cap. ffj quartis lioris. 



dm. 



M. 



Diaphoretic mixture. 

Ammonii benzoas, ammonii nitras, and ammonii phos- 
phas [Br.] are seldom if ever used. 



AMYGDALA— ALMOND. 

[Amygdala Amara. The kernel of the fruit of Amyg- 
dalus Communis, variety amara, U. S. 

Amygdala Duleis. The kernel of the fruit of Amyg- 
dalus Communis, variety duleis, U. S. 

Officinal Preparations, U. S. 

Mistura Amygdalae (used as a vehicle). 
Oleum Amygdala? Amara?. Dose, gtt. \ (.01 Gm.), 
in emulsion. 

Oleum Amygdala? Expressum (from A. duleis). 
Aqua Amygdalae Amara?. Dose, fgss (16. Gm.). 



148 STARCH — ANGUSTURA BARK. 

Syrupus Amygdalae (Orgeat syrup). Dose, f 3j to 
gss (4 to 16 Gm.). 

Unguentum Aquas Rosas (from oil of sweet almonds). 

Antidotes. 

The antidotes to poisoning by the preparations of bitter 
almonds are the same as those of hydrocyanic acid.] 

The bitter almond, being uncertain and dangerous, is never 
used in medicine ; but sweet almonds, in the form of the 
mixture or powder, are of value as agreeable vehicles for the 
mixture or suspension of other drugs, and Dr. Pavy has 
taken advantage of their nutritive properties to propose them 
as a substitute for bread in saccharine diabetes. 

[The effects of the oil of bitter almonds upon the system 
are identical with those of hydrocyanic acid, upon the pres- 
ence of which its activity depends, but it is about four times 
the strength of the officinal Acidum Hydrocyanicum Dilu- 
tnm. Bitter almond water, and the syrup, are used as vehi- 
cles for cough mixtures.] 



AMYLUM— STARCH. 

[ The feodum of the seed of the Triticum vulgare, U. S. 

Starch is used medicinally as an antidote to iodine, and as 
a demulcent in corrosive poisoning. In the form of a dusting 
powder it is applied to the skin of infants to prevent chafing 
and excoriation. It also makes a bland poultice.] 

Starch is a demulcent, used with advantage to some irri- 
table conditions of skin in the form of the glycerine of starch, 
and also as a medium for enemata. 



ANGUSTURA—ANGUSTURA BARK. 

[ The bark of Galipea officinalis, U. S.~\ 

Cusparia is a light tonic, rarely used. [It has fallen into 
disrepute, from the fact that it was occasionally found to be 
accidentally adulterated or mixed with nux vomica bark.] 



ANISE — ANTTMONY. 149 



ANISUM— ANISE. 

[The fruit of Fimpinella Anisum, U. S. 

Officinal Preparations, U. S. 

Aqua Anisi. As a vehicle. 

Oleum Anisi. Dose, gtt. v-xv (.30 to 1. Gm.). 

Spiritus Anisi. (Oil f'|j in Oj.) 

Anise is carminative and stomachic, and is a favorite 
flavoring ingredient in medicines for children.] 

Anise, Fennel, Coriander, Caraway, and Dill are agree- 
able aromatics, stomachics, and carminatives. 



ANTHEMIS— CHAMOMILE. 

[Thefoivers of Anthemis Nobilis, U. S. 

Officinal Preparations, U. S. 

Xnfusum Anthemidis. Dose, fjij (64 Gm.) as a 
tonic ; as an emetic ad lib. 

Oleum Anthemidis. Not officinal. Dose, gtt. v-xv 
(.30 to 1 Gm.). 

An agreeable aromatic ; in small doses it is drunk as a 
tonic, and in large doses the hot infusion is taken as an 
emetic. A poultice is sometimes made of the boiled flowers.] 

Chamomile has usually been considered a substance of no 
special therapeutic interest, being principally used by country 
people in the form of infusion as a remedy for dyspepsia; 
but within more recent years various German authorities, 
quoted by Phillips, have stated that the oil has a powerful 
lowering action on the reflex irritability of the spinal cord, 
and have proposed its use in cases of strychnia poisoning. 

ANTIMONIUM— ANTIMONY. 

[Officinal Preparations, U. S. 

Antimonii Sulphuretum — the purified tersulphide 
(used in making the oxide). 

Antimonii Oxidum. Dose, gr. ij-iij (.12 to .20 Gm.). 

Antimonii et Potassii Tartras. Dose, gr. T * ? to j 
(.005 to .00 Gm.). 

13* 



150 ANTIMONY. 

Antimonium Sulphuratum (sulphurated antimony). 
Dose, gr. j-xx (.06 to 1.30 Gra.). 

Antimonii Oxysulphuretum (Kermes mineral). 
Dose, gr. ss-j (.03 to .06 Gm.). 

Pilulae Antimonii Compositae. (6 grs. of the mass 
contain 1 gr. each of calomel and sulphurated antimony.) 
Plummer's Pills. 

Vinum Antimonii — (Tartar emetic, gr. ij ad fgj). 
Dose, gtt. x (.GO Gm.) ; as an emetic, f3j (4 Gm.). 

Emplastrum Antimonii (Tartrate of Antimony and 
Potassium, 1 part in 4). 

Unguentum Antimonii (Tartrate of Antimony and 
Potassium, 1 part to 4). 

Syrupus Seillse Compositus (contains Tartar 
Emetic gr. j in £j). 

Metallic antimony is not regarded as a poison ; but its 
vapor is said to cause unpleasant symptoms when respired. 

Antimony, Tartarized, generally known as Tartar Emetic, 
is an irritant metallic poison. 

Symptoms of Poisoning. 

Nausea and severe vomiting, hiccough, cardialgia, burning 
heat at the epigastrium, severe colic and purging, small and 
rapid pulse, cold skin, syncope, difficult respiration, vertigo, 
insensibility to external stimulants, painful cramps in the 
lower extremities, and great prostration of strength. 

Morbid Appearances. 

The stomach and intestines often much inflated with gas ; 
their mucous membrane red, and covered with a slightly ad- 
hering viscid layer ; the peritoneum of a dark brick-red hue; 
the membranes of the brain displaying marks of inflamma- 
tion.] Death may occur from the collapse following pro- 
longed vomiting and purging, or may be the result of gastro- 
intestinal inflammation. Post-mortem examination of a 
protracted case generally discovers parenchymatous degene- 
ration of the liver and other internal organs. 

[Tests. 

In a solid state, add charcoal, introduce into a test-tube 
and expose to heat ; metallic antimony will be deposited, of 



ANTIMONY. 



151 



a grayish-black lustre. In solution, diluted nitric acid causes 
a white precipitate. Sulphuretted hydrogen throws down a 
reddish-orange precipitate. Tannin causes a copious, curdled, 
whitish-yellow precipitate. Should matters from the stomach 
be present, the solution must be well agitated with a small 
portion of muriatic and tartaric acid, and filtered previous to 
being experimented upon. 



Treatment. 

Encourage vomiting by free administration of warm water 
and other diluents, or employ the stomach-pump, if neces- 
sary. Infusions, tinctures, or extracts, containing tannin, 
are very useful by decomposing the poison. Give tea, coffee, 
and stimulants.] 

Local Action. 



Physiological. 

Externally applied, tartar 
emetic causes redness and in- 
flammation of the skin, fol- 
lowed by an eruption of pa- 
pules becoming vesicular, and 
finally forming pustules close- 
ly resembling those of small- 
pox. 



Therapeutical. 

Tartar emetic used to be 
extensively employed in the 
form of ointment as a coun- 
ter-irritant, but was found 
occasionally to cause inflam- 
mation, and to leave unsightly 



Internal Action and Uses. 



I. Brain and Nervous Sys- 
tem — Tartar emetic under 
certain conditions, and more 
especially when combined 
with opium, exerts a sedative 
influence on the brain. 

When given in poisonous 
doses, paralysis, probably of 
spinal origin, and attended 
with diminished reflex irrita- 
bility, sets in. 

II. Circulation and Respi- 
ration — Antimony is seda- 
tive in its operation on the 
heart and vascular systems, 



I. Its use was originally 
recommended by Graves, and 
has been endorsed by Murchi- 
son, in the violent delirium 
of typhus, and it has also been 
employed with benefit in de- 
lirium tremens. 



II. The depressing influ- 
ence of tartar emetic on the 
circulation caused it to be 
very generally used in former 



152 



ANTIMONY. 



the hearts's action becoming 
slow, weak, and finally irreg- 
ular, the arterial tension low- 
ered, and the pulse soft and 
compressible. The respira- 
tion also grows slower, and 
an increased secretion takes 
place from the bronchial mu- 
cous membrane. 



General muscular relaxa- 
tion is observed. 



III. On Secreting Organs. 

1. Stomach and Intestines 

Antimony is an effectual 
emetic, its action being slow, 
however, and attended by a 
good deal of depression. It 
acts either when swallowed, 
or by subcutaneous injection ; 
but the balance of experiment 
goes to show that in either 
case the effect is produced by 
reflex action following irrita- 
tion of the nerves of the sto- 
mach. Some increase of se- 
cretion from the intestines 



years in acute inflammations, 
and more especially pneumo- 
nia ; but this practice has 
now been almost generally 
abandoned, as it was found 
that such treatment, whilst 
exerting no real influence 
over the course of the disease, 
tended to reduce the strength 
of the patient, and cause lin- 
gering convalescence. Small 
doses, however, are found use- 
ful in croup [when not diph- 
theritic], and in the broncho- 
pneumonia of children where 
great dyspnoea and fever exist 
with excessive bronchial se- 
cretion ; and it is a good gene- 
ral expectorant in asthma, 
[the first stage of] bronchi- 
tis, etc. 

Its relaxing effects on the 
muscular system were former- 
ly taken advantage of for the 
reduction of hernice and dis- 
locations; but it has of course 
been quite superseded by chlo- 
roform and other anaesthetics. 

1. Antimony is too slow 
and depressing an emetic to 
be used in cases of poisoning, 
but it is of service in croup, 
tvhooping-cough, bronchitis, 
etc., where we wish to relax 
the bronchi and get rid of ac- 
cumulated secretions. 

In former years, when an- 
timony was freely given, what 
was called tolerance used to 
be an interesting therapeutic 
result. This is to say, in 
feverish conditions, it was 



ANTIMONY. 



153 



and consequent diarrhoea are 
occasionally observed. 



2. In poisonous doses an- 
timony causes irritation and 
inflammation of the stomach 
and intestines. 

3. Skin Antimony has a 

powerful diaphoretic action. 



found that large quantities of 
the drug might be taken with- 
out producing vomiting ; and 
this has been explained by 
the observation that anti- 
mony, to act as an emetic, 
must previously be dissolved 
in the gastric juice, a secre- 
tion which is in great mea- 
sure checked during fever. 
Gubler explains the tolerance 
more simply, by suggesting 
that the system is too weak to 
carry out the energetic series 
of actions causing vomiting. 



3. Antimonial wine is a 
common adjunct to diapho- 
retic mixtures. It has been 
used in small doses with good 
result in psoriasis from its 
chemical relationship with 
arsenic. 



Commonly used Preparations. 

Antimonium tartaratum (Br. P.). [Antimonii et Potassii 
Tartras.] Dose, -f^ gr. to J gr. ; as emetic, 1 to 3 grs. (.004 
to .2 Gm.). In the bronchitis of children, from ¥ L gr. to 
T V gr. (.1 to .3 Gm.). 

Vinum Antimonii. Dose, 15 to 40 minims. 

Ung. Antimoni tartarati. [Unguentum Antimonii, U. 
S. P.] 

Pulvis Antimonialis. This is the patent preparation known 
as James's powder, which used to be more popular than it is 
now. 

None of the other preparations of antimony have any spe- 
cial therapeutic value. 



154 ANTIMONY. 



Mode of Elimination, etc. 

Tartar emetic rapidly enters the blood, and is eliminated 
by the bile, milk, sweat, and urine, as well as the gastro- 
intestinal glands. 

Form of Administration. 

Tartar emetic, on account of its tastelessness, may be well 
given dissolved in simple distilled water ; and Ringer tells 
us, and I have amply confirmed his statements, that we may 
do much good, in some forms of acute bronchitis in children, 
by dissolving a grain of the salt in a pint of water, and giv- 
ing a teaspoonful every quarter of an hour for the first hour, 
and then hourly. 

In the case of adults, when we wish to avoid the nauseat- 
ing effects of the drug, we may best do so by the following 
formulae : — 

R. Antimonii et potassii tart. gr. ij ; or 12 Gi 

Acidi hydrocyanici diluti rri^xxx ; 

Spiritus lavandulae comp. f §ss ; 

Aquae destillatse q. s. ad f§vj ; 
Dose, f §ss quartis lioris. 1 

R. Liq. opii sed. 2 f £j ; 

Antimon. et potass, tart. gr. j ad gr. ij 

Aquas camphoras f §vj ; " 192; " M. 

S. Sumat seiniunciam omni liora douec sorcmus supervenerit. 

Highly recommended by Graves and Murchison in the 
insomnia and delirium of typhus fever. 

[Tartar emetic in broken doses is very useful in acute 
pneumonia, from its action on the skin as well as on the 
respiratory centre. The following formula has been used in 
Philadelphia for a number of years, having been introduced 
by the late Dr. Pepper, one of the physicians to the Penn- 
sylvania Hospital : — 



2 


" 


16 


1 1 


192 


a 


4' Gm 


192 


06 " 



R. Antimonii et potassii tart. gr. ^; 


or 




03 Gm. 


Pulv. digitalis gr. x ; 


i i 




60 " 


Pulv. ipecac, comp. gr. xl ; 


a 


2 


60 " M. 


Ft. chart, no. xx. 






S. Capiat unam secunda quaque hora. 









1 [Each dose contains two and one-half minims of dilute hydro- 
cyanic acid. This being the case, the first dose should not exceed 
f 5J ; to he cautiously increased.] 

2 [Battley s solution, non-officinal. It is about twice the strength 
of laudanum.] 



WATER. 155 

AQUA— WATER. 

{Natural water in the purest attainable state, U. S. 

Aqua Destillata. Distilled water.] 

Water, both in its external and internal applications, en- 
ters so largely into medical practice as well as into domestic 
economy, that we cannot begin our studies better than by 
considering very briefly what is definitely known regarding 
its physiological and therapeutical properties. 

[Water being the universal solvent is not found pure in a 
natural condition, but is more or less impregnated with saline 
or organic matters, and always contains in solution more or 
less solid, liquid, or gaseous impurities. Pure water boils at 
100° (212° F.) at the level of the sea; if it contain much 
foreign matter, its boiling point may be raised. Mineral 
waters are those which permanently contain an unusual 
quantity of saline substance in solution. Hard water con- 
tains carbonate or sulphate of lime and magnesia ; the former 
being remediable by boiling is called removable hardness, 
while the latter is permanently hard. Hard water will not 
make a lather with the ordinary alkaline soap, but simply 
curdles, because the lime combines with the fatty acids and 
is precipitated. This is the basis of division of water into 
hard and soft ; spring and well water are often hard; rain 
and river water are usually soft. 

The following classification of water is furnished by the 
Rivers Pollution Commissioners in their sixth report, etc. : — 

I. In respect of wholesomeness, palatability, and general 
fitness for drinking and cooking — 





\ L 


Spring water *) 
Deep well water ) 


Very 


Wholesome - 


2 - 


palatable. 




(3. 


Upland surface water | 


Moderately 




{ h 


Stored rain water j 


palatable. 


Suspicious 


r 


Surface water from ] 
cutivated land 






\ h 


River water, to which y 


Palatable. 


Dangerous. • 




sewage gains access j 






I 2. 


Shallow well water 





II. According to softness- 

1. Rain water. 

2. Upland surface water. 



156 WATER. 

3. Surface water from cultivated land. 

4. Polluted river water. 

5. Spring water. 

6. Deep well water. 

7. Shallow well water. 

III. In respect of the influence of geological formation in 
rendering water sparkling, colorless, palatable, and whole- 
some by percolation, the following water-bearing strata are 
given as most efficient — 

1. Chalk. 

2. Oolite. 

3. Green sand. 

4. Hastings sand. 

5. New red and conglomerate sandstone.] 1 

Baths and External Applications. 

It will be found difficult, if not impossible, to balance the 
physiological and therapeutical actions of water in the manner 
followed generally throughout this work, and we shall there- 
fore give a short collective sketch of the influence exerted by 
it on the various functions of the body. 

It is not necessary for us to do more than refer to the uni- 
versal use of water for washing and bathing purposes, but a 
word or two on the physiological effects of cold baths is re- 
quired. We find that the action of the heart is increased, 
the respiration may become panting and irregular, the tem- 
perature falls, and the destructive metamorphosis of muscular 
tissue is augmented, as indicated by an increased excretion 
of urea; occasionally albumen appears in the urine, and so 
much mental shock is produced, more especially by sea- 
bathing, as to render this usually excellent tonic unad- 
visable in those of feeble or hysterical constitution, in the 
very young and old, and in pregnant or menstruating women, 
whilst the tendency to vascular strain must prescribe caution 
towards those in whom we have any reason to suspect aneu- 
rism or a degenerated state of the arterial system. 

Occasionally, during sea-bathing, the hair falls off, the 
process of digestion becomes impaired, and sleeplessness is 

1 [Given by Wilson, in his " Handbook of Hygiene," Am. ed., 
Philada., 1877, pp. 141-142.] 



WATER. 157 

experienced ; and this, no doubt, arises from the process of 
tissue destruction not being thoroughly balanced by repair. 

As regards the external uses of cold water in medical prac- 
tice, we may refer to the beneficial action of water-dressing 
and irrigation in surgery, to cold affusion in laryngismus 
stridulus, cholera, hysteria, the stupor of fevers and drunken- 
ness, and, most of all, to the wonderful refrigerant action of 
cold baths in cases of abnormally high temperatures. 

It is generally held that a fatal result almost inevitably 
occurs in any case where the bodily temperature remains 
above 107° for several days at a time, and until very recently 
Ave were powerless to check the destructive influence of this 
complication. Within the last few years, however, Drs. 
Wilson, Fox, and others have shown that we may safely and 
effectually bring down this excessive heat in rheumatism, 
where it principally occurs, by placing the patient in a bath 
at 95° and gradually adding cold water or ice until 60° Fahr. 
is reached. In this way a reduction of from seven to twelve 
degrees may be readily effected, but we must remember one 
practical point, that the patient's temperature continues to 
fall, as much even as six degrees, for forty or fifty minutes 
after he has been removed to bed, in consequence of the pri- 
mary contraction of the vessels of the skin, due to the fever 
and the cold water, being succeeded by relaxation and con- 
sequent irradiation of heat (Binz). Four or five baths may 
be required during the first day of treatment, the patient 
remaining immersed during twenty or thirty minutes. There 
can be no doubt that by watching our cases of rheumatism 
carefully, and adopting this mode of treatment whenever the 
thermometer registers more than 105° Fahr., we may save 
many lives. We may remember that the lowering effect is 
in inverse proportion to the weight of the body, and that the 
best effects are produced at the time when the temperature 
has a tendency to sink spontaneously, as from seven in the 
evening till morning, and again from 11 to 2 in mid-day. 
We must beware of collapse, which is no imaginary danger, 
and must be met by stimulants. 

The Germans use the cold bath very freely in all febrile 
disorders. Liebermeister keeps his patients in the water for 
even two hours in severe cases ; but there is no evidence that 
their success is greater than under the treatment pursued in 
this country, which has the merit of being agreeable to the 
feelings of the sufferer. 
14 



158 WATER. 

Cold packing is an excellent stimulant to the skin; it is 
useful as a less effectual but more agreeable mode of usino- 
antipyretic treatment, and is of service in acute eruptive dis- 
orders, when the rash tends to recede ; and is extensively 
employed at our hydropathic establishments. 

Warm water is also very serviceable, and we may mention 
the soothing action of warm fomentation, the warm douche 
in early joint disease, and the use of the warm bath in the 
convulsive diseases of children, for the relief of colic, spas- 
modic stricture, hernia, gall or renal calculi, and in cases of 
extensive burns or moist skin diseases, employed after the 
manner of Hebra, whose patients frequently remain in a state 
of continuous soaking for days together. 

Ice is a most valuable application for relieving pain and 
checking inflammation in orchitis, bubo, meningitis, etc., as 
well as for the arrest of hemorrhage, and to allay thirst and 
obstinate vomiting ; and introduced into the rectum it pro- 
duces some antipyretic action. 

Vapor is often used as a soothing and relaxing application 
in tonsillitis, bronchitis, croup, etc., and, in the form of bath, 
to cause diaphoresis. 

Constitutional Action. 

\Vhen water is taken internally, it acts in some measure 
as a purgative by supplying moisture to the feces ; it pro- 
motes digestion by stimulating the secretion of gastric juice, 
and aiding the passage of peptones into the blood (Ringer) ; 
and it is in some measure a diuretic, increasing temporarily 
the excretion of chloride of sodium, and more permanently 
the elimination of urea, phosphoric and sulphuric acids by 
the urine. It is, of course, the universal solvent, and its 
importance in the animal economy is shown by the fact that 
it constitutes about sixty-eight of the hundred parts which 
build up our entire bodily frame, and that five pints are 
given out from the body of one average-sized adult in the 
twenty-four hours. The urgent necessity for its purity is 
further proved by the leading part it has always taken in the 
spread of epidemics ; for not only cholera, but enteric fever, 
has thus been largely propagated, whilst entozoa are thus 
introduced into the system, and the presence of other impu- 
rities may give rise to dysentery, diarrhoea, goitre and 
yellow fever. [The most dangerous adulteration of drinking 



WATER. 159 

water is that occasioned by the presence of decaying organic 
or albuminoid matter. Daring epidemics of bowel affections, 
all water should be boiled previous to drinking.] Specific 
adulterations also, like lead, have frequently occasioned very 
painful and even fatal attacks of illness. 

But we may derive great benefit in practice from the use 
of some of those very impure waters, deeply impregnated 
with various mineral ingredients, which are known as mineral 
waters, and which are met with in such profusion and variety 
both at home and abroad. Fashion, no less than undoubted 
success attending their use, has now brought these natu- 
rally adulterated waters prominently forward, and it is very 
esssential that every practitioner should have some knowledge 
of their chief constituents and the principal health resorts 
where they can be partaken of in greatest perfection. Our 
present limits, however, will only permit a very bare enume- 
ration of the principal classes into which mineral waters have 
been divided. 

1st. We have the chalybeate or ferruginous class, which 
contains iron in varying proportion, in the form either of 
carbonate held in solution by carbonic acid gas, as at [Ex- 
celsior Rock Spring, Saratoga] Spa, Tunbridge Wells, and 
Harrowgate ; or of sulphate, as at [Bedford Springs, Pa., 
Fairmount Park, Phila.] Brighton, Isle of Wight, etc. Some 
are hot and some cold, and some, as Monte Dore, contain a 
minute quantity of arsenious acid. They are possessed of 
tonic properties, and are very useful in cases of anremia, 
chlorosis, struma, and other conditions of debility ; and 
whilst as carbonate we generally find them well borne, we 
must be cautious of their use in very plethoric and full- 
blooded patients. 

2d. Acidulous or carbonated. These are agreeable and 
sparkling, holding in solution carbonates of lime, soda, and 
magnesia. They are met with at [Gettysburg] Seltzer, and 
Carlsbad, and are serviceable in gout and dyspepsia. 

3d. Saline, some of which are purgative by containing the 
sulphates of magnesia and soda, as at [Saratoga, Empire 
Spring] Cheltenham, Leamington, Friedrichshall, etc. ; 
others, as Buxton, Bath, and Bristol, are impregnated with 
carbonate and sulphate of lime ; others with chlorides, as 
Weisbaden, Baden-Baden; a fourth class contain iodine and 
bromine in combination with sodium and magnesium, as at 
Homburg, Kissingen, Woodhall, etc. ; whilst a fifth class, as 



160 SILVER. 

at Vichy and Ems, owe their properties to the alkaline car- 
bonates which they contain. [Apollinaris and Hunyadi 
Jan os waters belong to this class.] These waters are much 
used for their tonic and aperient action. 

4th. Sulphuretted or hepatic waters contain sulphuretted 
hydrogen in solution, and possess a very offensive taste and 
smell. They are generally thermal, frequently having a 
high temperature. They are chiefly met with at Harrow- 
gate, Moffat, Cheltenham, Aix-la-Chapelle [Virginia Sulphur 
Springs], Bareges, Eaux Bonnes, etc., and are principally 
used in chronic skin diseases, in chronic rheumatism and 
bronchitis, in advanced syphilis, and for the elimination of 
mercury. 

Those patients who are unable to visit the different spas 
at home or abroad, may drink the bottled waters, or we may 
manufacture rough imitations by combination of the various 
ingredients. In prescribing saline purgatives, we should 
always remember the principle of very free dilution and 
frequently repeated small dose on an empty stomach ; but, 
although we may often do great good by this mode of admin- 
istration, we miss the change of air and scene, the early and 
regular hours, the simple diet, and the special faith and 
mental anticipation with which the chronic rheumatic and 
dyspeptic approach the health resort of their choice. 



[Aquae. 

The class of Medicated Waters in the U. S. Pharma- 
copoeia includes the following : — 

Aqua Acidi Carbolici Aqua Chlorinii 

" '' Carbonici " Cinnamomi 

" Ammonise " Creasoti 

" Ammonise Fortior " Destillata 

" Amygdalae Amarae " Foaniculi 

" Anisi " Menthse Piperitae 

" Aurantii Florum " Menthse Viridis 

" C amphorae " Rosse.J 



ARGENTUM— SILVER. 

[Officinal Preparations, U. S. 

Argenti Cyanidum — for making Acidum Hydrocy- 
anicum Dilutum for immediate use. 

Argenti Nitras. Dose, gr. J-ij (.01 to .12 Gin.). 



SILVER. 



161 



Argenti Nitras Fusa — Lunar Caustic, for external 
use. 

Argenti Oxidum. Dose, gr. ss-ij (.03 to .12 6m.), in 
pill. 

Antidote. 

The chemical antidote to nitrate of silver is table salt, 
which should be followed by an emetic or a purgative. 

Metallic silver is inert. As it occasions no chemical irri- 
tation in the tissues, canulse are made of it for use in empyema 
to wash out the chest, etc., and silver wire is also used in sur- 
gery to unite the fractured ends of bones where there is 
delayed union, and for sutures in wounds of the scalp and 
elsewhere. The salts of silver are best administered in pill 
form, for which gum Arabic is probably the best excipient, 
as with vegetable extracts, or glucose, they are apt to ex- 
plode.] 

Local Action. 



Physiological. 

The nitrate of silver pri- 
marily hardens, but seconda- 
rily destroys, the cuticle, and 
condenses the tissues by co- 
asulatinor their albumen. 



Its application may cause 
ulceration of the healthy skin, 
and it is often used to check 
the activity of granulating 
surfaces. 



Therapeutical. 

Nitrate of silver, either in 
substance or solution, has 
been used to check the spread 
of erysipelatous inflamma- 
tion ; to arrest the pitting of 
smallpox; and to avert the 
formation of bed-sores. 

It is a good injection for 
gonorrhoea, or collyrium for 
conjunctivitis, and a strong 
solution is one of our best 
remedies for various relaxed 
or ulcerated conditions of the 
fauces. In substance, lunar 
caustic forms a good applica- 
tion to simple venereal sores, 
ulcerated tonsils, or to any 
ulcerating or granulating tis- 
sue, when we wish to repress 
exuberant granulations or ex- 
cite a new and more healthy 
action. 



14* 



162 ARNICA. 



Internal Actions and Uses. 

Silver nitrate is little employed internally. It formerly 
enjoyed a considerable reputation in the treatment of nervous 
disorders ; but we do not now hold it in such high esteem. 
I have, however, found its cautious use to be of distinct ser- 
vice in those cases of epilepsy where bromide of potassium 
has lost its control over the disease. [In the treatment of 
the various forms of spinal sclerosis, especially locomotor 
ataxia, Dr. Seguin regards the salt as of great value, thus 
endorsing the views of Erb. He also uses it in myelitis. A 
quarter to half a grain may be given, before meals, three 
times daily, and continued for several months. He had never 
observed symptoms of argyria from its use in these doses.] 
For severe gastralgia, which has resisted other modes of 
treatment, nitrate of silver is undoubtedly a very effective 
remedy ; and occasionally patients willingly run the risk of 
disfigurement in the hope of cure. In one case which I 
have had the opportunity of examining, the man was well 
pleased to have lost in three months his incessant pain at the 
expense of permanent staining, the bluish color being much 
deeper on the face, from the action of the light, and being 
almost invisible on the gums, throat, and conjunctivae. [The 
oxide has been highly recommended as a nervous sedative, 
and has been used with good results in the treatment of loco- 
motor ataxia. It is said, also, to act as a haemostatic in 
menorrhagia.] 



ARNICA—ARNICA. 

[The flowers of Arnica Montanum, U. S. 

Officinal Preparations, U. S. 

Extractum Arnicae. Dose, grs. v-x (.30 to .GO Gm.). 
Emplastrum Arnicas (extract J). 
Tinetura Arnicas (Jiij-Oj). Dose, gtt. x-xxx (.G5 
to 2 Gm.), well diluted.] 

External Actions. 

If applied to the skin for Some practitioners value 

some time, arnica causes red- arnica highly for the power 

ness and irritation, and in which they believe it to pos- 

some susceptible subjects sess of absorbing bruises and 



ARNICA. 



163 



most violent erysipelatous 
inflammation, even ending in 
death, has resulted. It must 
therefore be used with cau- 
tion. 



Physiological. 

[Prof. Bartholow sums up 
its action as follows : In- 
creases flow of saliva ; causes 
nausea and vomiting ; even 
irritant poisoning may result; 
it increases secretion from 
mucous membranes. It rap- 
idly diffuses into the blood, 
and in small doses acts as a 
stimulant, increasing the ac- 
tion of the heart, producing a 
general feeling of warmth 
throughout the body ; it in- 
creases the secretion of the 
kidneys and the sweat glands. 
In larger doses the stimulat- 
ing effect is shorter in du- 
ration, and is followed by 
vomiting, depression, or col- 
lapse. Death is caused by 
arrest of action of the heart. 



relieving sprains. Dr. Gar- 
rod, on the other hand, as- 
serts that any power it seems 
to exercise in dispersing ex- 
travasations of blood is sim- 
ply due to the spirit which 
the tincture contains. Dr. 
Phillips, again, tells us that 
the irritating effects never 
follow the use of an aqueous 
solution, which contains none 
of the arnicine or volatile oil. 

Therapeutical. 

Arnica has not been used 
much internally, but recent in- 
vestigations show that it may 
well be employed as a cardiac 
stimulant in low grades of fe- 
ver, in small doses, frequently 
repeated. In order to de- 
press the temperature and ac- 
tion of the heart larger doses 
will be required. In delirium 
tremens, where restlessness is 
due to debility, small doses 
may be used, in mania, with 
high arterial excitement, 
large doses will be called for. 
It has also been recommended 
in a similar mode of employ- 
ment in acute rheumatism 
and rheumatoid arthritis. 



Poisoning. 

Poisonous doses cause dilated pupils, pain in the head, 
and stupor due to accumulation of carbonic acid in the blood. 
Atropia is the physiological antidote.] 



1G4 ARSENIC 



Internal Actions. 

The physiological and medicinal actions of arnica can only 
be balanced with difficulty, as the evidence regarding the 
former is very conflicting, and the opinions on the latter cer- 
tainly err in the direction of over-confidence. As it is rarely, 
if ever, used as a medicinal agent save by homoeopathic prac- 
titioners, it does not seem necessary to say more about its 
asserted virtues. 



ARSEN1CUM—ARSENIC. 

[Acidum: Arseniosum:. Sublimed arsenious acid in 
masses, U. S. Dose, gr. gV* 

Of.ficinal Preparations, U. S. 

Arseniei Iodidum. Dose, gr. J (.008 Gm.). 

Liquor Arseniei et Hydrargyri Iodidi (rtr xx 
contains arsenic gr. ^ ? ). Donovan's solution. Dose, rtT, x 
(.60 Gm.). 

Liquor Arseniei Chloridi. (Acid, arsen. gr. iv ad 
f 5J.) Dose, nrv (.30 Gm.). 

Liquor Potassii Arsenitis. (Acid, arseniosum, gr. 
iv ad 1 5 j. ) Fowler's solution. Dose, nrv (.30 Gm.). 

Liquor Sodii Arseniatis. (Sodii arseniat. gr. iv ad 
f'5j.) Dose, nrv (.30 Gm.). 

Sodii Arsenias. Dose, gr. T \ (.005 Gm.). 

Metallic arsenic is inert, and is not used in medicine. 
Arsenious acid is sometimes termed white arsenic, or, simply, 
arsenic, as in the following remarks. It is a corrosive 

poison.] 

Poisonous Effects. 

Poisoning by arsenic is ushered in by [a metallic taste in 
the mouth, salivation, nausea, fainting, great thirst, and a 
burning pain in the stomach, vomiting, diarrhoea. The 
stools are dark colored and very offensive, the urine scanty 
and high colored. The pulse is weak and often intermits ; 
there is distressing palpitation of the heart, with labored 
respiration and cold sweats. There is prostration, sometimes 
paralysis, andj headache, fever, and disturbed sleep, fol- 



ARSENIC. 165 

lowed by more acute symptoms and death from collapse — a 
train of symptoms much resembling those met with in cases 
of true cholera. [Such phenomena occurring in the absence 
of any epidemic of Asiatic cholera, and coming on soon after 
eating, in a previously healthy person, should excite suspi- 
cion of arsenical poisoning.] 

After death, there will be the usual pathological appear- 
ances of gastro-enteritis [but without erosion or abrasion, 
and most marked in the stomach, duodenum, and the rectum. 
Sometimes there are few or no morbid appearances in these 
situations; for instance, where it has been administered in a 
vaginal injection. In some cases the gastro-enteric symp- 
toms are not prominent, or are entirely absent, and the 
patient is found to have marked depression of the vital 
powers, and a progressive tendency to coma and collapse, 
showing that the force of the poison has been chiefly ex- 
pended upon the nervous system. Recent researches have 
shown by chemical analysis a relatively larger proportion of 
arsenic in the nervous centres than in other tissues of the 
body.] Frequently we find fatty degeneration of the heart 
and muscles, and parenchymatous degeneration of the liver, 
kidneys, etc. [Arsenic may generally be detected in the 
liver, or contents of the stomach, by Reinsch's or Marsh's 
Test. 

Antidotes. 

The chemical antidotes to arsenious acid are freshly pre- 
pared hydrated sesquioxide of iron, and magnesia freshly 
calcined. The solution of dialyzed iron is a convenient anti- 
dote for arsenical poisoning. When Fowler's solution has 
been taken the ferric salts are the antidotes. 

Treatment. 

Abundant draughts of sweet milk, gruel, decoctions of 
starch, or oily mixtures ; tickling the fauces, etc., to induce 
vomiting; the stomach-pump; emetics of sulphate of zinc. 
Hydrated sesquioxide of iron, newly prepared, in large doses, 
or in the form of dialyzed iron, affords the only reliable 
antidote. 

The magnesia may be used with advantage, until hydrated 
peroxide of iron can be procured. Having removed the 
poison by vomiting and purging, we afterwards combat any 



166 ARSENIC. 

inflammatory symptoms by the usual means, and let the pa- 
tient subsist, for a long time, wholly on the blandest diet. 

Tests for Arsenic. 

In the solid state it can be sublimed by heat. If mixed 
with charcoal, and heated in a suitable test-tube, deoxi- 
dated arsenic will be obtained in the form of a metallic 
coating inside the tube ; and this may be reconverted into 
arsenious acid by urging it in various directions along the 
tube with the aid of a minute spirit-lamp flame ; the facets of 
the crystals thus formed (on the cooler situations) will be 
seen in some places with the unassisted eye, but more dis- 
tinctly by means of a four-power lens. 

In solution, ammomacal nitrate of silver produces a lemon- 
colored (arsenite of silver) precipitate. Ammoniacal sul- 
phate of copper throws down a grass-green (arsenite of 
copper) precipitate. Transmission of sulphuretted hydrogen 
produces a bright yellow (sulphide of arsenic) precipitate. 
Lime-water precipitates a white (arsenite of calcium) pow- 
der, but this test is not one to be relied upon. 

Marsh's Test Placed with zinc and diluted sulphuric 

acid in the hydrogen apparatus, the arseniuretted hydrogen 
thence arising, when lighted, will deposit metallic arsenic on 
a piece of glass held within the flame. 

Reinsch's Test Acidulate the suspected liquid with 

muriatic acid, and boil copper wire or foil in it for ten min- 
utes. The arsenic is deposited on the copper as a white 
alloy, from which it can be separated as arsenious acid, by 
subjecting the copper, cut into shreds, to a low red heat in 
the bottom of a small glass tube. 

The precipitates referred to, if washed and dried, may be 
treated as directed above for arsenic in the dry or solid con- 
dition. 

In testing suspected matters obtained from the stomach, 
these, and in cases of death, the viscera themselves, must be 
cut or broken up, and boiled during, at last, three-quarters of 
an hour ; if not sufficiently fluid, add distilled water. Strain, 
add a small quantity of potassa, and again boil during a 
quarter of an hour, and filter. If this liquor manifest either 
alkaline or acid reaction, neutralize with potassa, or with 
acetic acid, as may be required ; then acidulate it faintly 
with hydrochloric acid. The liquor may now be experi- 
mented on with the above tests.] 



ARSENIC. 



167 



Local 

Physiological. 

Externally applied, arsenic 
causes redness and inflamma- 
tion of the skin, followed by 
ulceration and sloughing. If 
we wish to use it as a caustic 
we must apply it freely to 
prevent bad results, remem- 
bering that if we produce in- 
flammation of a part we check 
its absorptive powers. [It is 
considered safer to limit the 
application to a small surface 
at a time on this account.] 



Action. 

Therapeutical. 

Arsenic has been employed 
as a caustic in cancer and 
allied diseases ; but not only 
is its action difficult to regu- 
late, but dangerous symptoms 
of poisoning have resulted 
from the very ready way in 
which it is absorbed by the 
skin. As a more gentle form 
of stimulant, however, it is of 
great service in some chronic 
skin diseases, such as lupus. 



Internal Actions and Uses. 



I. On Brain and Nervous 
im. — Arsenic has a tonic 
influence on the nervous sys- 
tem generally. 



II. Circulation and Re- 
spiration In small doses 

arsenic may stimulate cardiac 
action in a slight degree ; and 
the experience of the arsenic- 
eaters of Styria shows that 
its use improves their wind, 
and enables them to undergo 
great exertion without fa- 
tigue. This fact, which was 
formerly denied, has been 
placed beyond all doubt by 
the observations of Macla- 



I. This may in some mea= 
sure explain its antiperiodic 
properties, for it is well 
known that arsenic is only 
second to quinine in its power 
of arresting the various man- 
ifestations of ague. 

It is also a valuable remedy 
in neuralgia, and chorea may 
frequently be cured by full 
doses. 

II. Arsenic is of service 
in asthma, hay-asthma, per- 
haps by calming irritability 
of the vagus, and some forms 
of chronic bronchitis and 
chronic phthisis, and has been 
found to act well by the in- 
halation of spray. 

The Monte Dore waters, 
so much recommended m 
asthma, are believed to owe 
their efficacy to the arsenic 
which they contain. 



168 



ARSENIC. 



gan, who, after seeing an 
arsenic-eater consume his 
dose, detected the presence 
of the metal in the urine. 
Either arsenious acid or or- 
piment is used, and the lar- 
gest dose is said to be 14 
grains, 8 grains having been 
actually eaten in presence of 
a competent witness. It is 
stated, however, that only 
persons of strong constitution 
can bear this habit. 

III. On the Secreting Or- 
gans. — 1. Digestive Tract. 
In small doses arsenic stimu- 
lates the appetite and in- 
creases the digestive powers, 
but if used more freely symp- 
toms of irritation set in, 
which may terminate in gas- 
tro-enteritis. [Some patients 
cannot take the smallest doses 
without great systemic dis- 
turbance. It is advisable to 
begin with minute doses and 
cautiously increase, watching 
the effect.] 



III. Ringer recommends 
small doses of arsenic — 1 . In 
a form of irritative dyspepsia 
with red tongue and promi- 
nent papillae, in the morning 
vomiting of drunkards, and 
in that variety of diarrhoea 
which leads to the evacu- 
ation of the bowels imme- 
diately after eating. That 
the nutrition of the skin is 
profoundly affected by ar- 
senic, is proved by experi- 
ments which show that des- 
quamation of the epidermis, 
and degeneration and partial 
solution of the protoplasm of 
the cells of the cutis vera, re- 
sulted in frogs poisoned with 
the drug. We may explain 
the success of arsenic in cu- 
taneous disorders either by 
its influence on the nutrition 
of the cell-growth of the 
skin, or by its action on the 
nervous system, it being an 
undoubted fact that its cura- 
tive powers are almost re- 
stricted to those diseases 
which are of neurotic origin. 



ARSENIC. 



169 



2. Cutaneous Arsenic 

occasionally causes irritation 
and tingling of the skin, and 
even the appearance of ecze- 
matous and occasionally her- 
petic eruptions. 



3. Liver. — Arsenic in poi- 
sonous quantities causes, like 
phosphorus, fatty or, paren- 
chymatous degeneration of 
the liver. 

15 



Excellent though its effects 
frequently are, it will often 
prove disappointing, and will 
fail to cure the disease for 
which it is given. But in 
psoriasis, if we get the case 
early, and treat it regularly 
and rigidly, continuing the 
administration of the drug in 
small doses for some time 
after the eruption has disap- 
peared, we may usually hope 
for jrood results, remembering 
that relapses are extremely 
common in this disease. 
Some authorities hold that in 
order to get full value from 
the use of arsenic, we must 
produce physiological symp- 
toms, but my own experience 
is entirely opposed to this. 

2. In dry scaly affections 
of the skin, such as psoriasis, 
in the dry stages of eczema 
and impetigo, in pemphigus, 
and in lichen, arsenic acts 
most admirably; but we must 
be careful never to give it 
during the acute stage of any 
skin ajfection, as in these 
circumstances, it is invariably 
found to aggravate the symp- 
toms. Arsenic is much val- 
ued by Balfour and others 
in chronic rheumatism, and 
more especially rheumatoid 
arthritis. 

3. [Arsenic in small doses 
is a valuable stimulant to the 
hepatic tissue changes, and is 
useful in incipient cirrhosis 
and in certain forms of intes- 
tinal indigestion.'] 



170 



ARSENIC. 



4. On Urine Nothing 4. Dr. Lander Brora ton re- 
special has been described cords an interesting case in 
[except that the kidneys and winch arsenic cured albumi- 
liver are the principal chan- nuria in a young man, due 
nels for the discharge of the probably to imperfect pan- 
poison from the circulation.] creatic digestion of albumen. 

Mode of Elimination. 

Arsenic is rather slowly removed from the body by the 
intestines, the urine, and perhaps the bile and the skin. 
Traces have been found in the urine sixteen days after in- 
gestion. 

Mode of Administration, Cautions, etc. 

Persons vary much in their susceptibility to arsenic, and 
we must invariably begin its use with caution, keeping in 
mind that children bear it well, and that a child of five can 
bear with impunity as large a dose as an adult. [Two 
grains of arsenious acid have caused death, according to Dr. 
Taylor.] 

We must also remember that, although the Styrian peas- 
ants can accustom themselves to large and increasing doses, 
the experience of medical practice shows that, after a certain 
time, patients taking this drug are liable to show some of the 
following symptoms : Smarting and itching about the con- 
junctiva:', with oedema, pain in the stomach, vomiting and 
diarrhoea, white tongue, and general digestive derangement; 
and when these indications of " accumulation" occur, it is 
not necessary to suspend the remedy altogether, but merely 
to diminish the dose. 

The probabilities of these unpleasant symptoms are much 
lessened, however, by advising that the dose should always 
be taken after a meal. 

The mode in which arsenic is usually given is in the form 
of liq. arsenicalis [Fowler's solution — Liq. Potass. Arsenitis, 
U. S.], which is merely a solution of arsenious acid in car- 
bonate of potash flavored with sp. lavand. co., containing 
gr. ss in fjj, and of which the dose is, as a general rule° 
from rci ij to tttv (.13 to .32 Gm.) ; but in some obstinate 
affections, like chronic rheumatic arthritis, it is requisite to 
push the quantity as far as tti,x or even r^xv (.65 to 1. Gm.). 
In skin diseases I am strongly in favor of beginning with a 
large dose, and pushing the drug vigorously. Small doses 



ASSAFETIDA.. 171 

seem more likely to provoke irritation than large. Being al- 
most tasteless, liq. arsenicalis is best given simply in water. 
The liquor arsenici chloridi, sodii arsenias, and ferri arse- 
nias are rarely used ; and the liquor arsenici et hydrargyri 
iodidi [Donovan's Solution], which was supposed to have 
a special influence over syphilitic skin diseases on acount 
of its combination of arsenic with iodine and mercury, has 
gone much out of fashion in these days. Dose, 10 to 30 
minims (.65 to 2. 6m.). [The iodide of arsenic is sometimes 
used as an ointment in skin affections (gr. iij to §j.) Simple 
ointment with arsenious acid (gr. j to £j) has been highly 
recommended as an agreeable substitute for sulphur ointment 
in the treatment of scabies.^ 

fy. Hydrargyri chloridi corrosiv. ^iiss or 10 Gm. 

Hydrargyri bisulphureti gr. xl " 2 60 " 

Acidi arseniosi 5) ' 

S. To be made into a paste with a little water, 
applied with a brush. 

Useful in cases of lupus. 

I£. Vini ferri f5.i c 

Liq. potassii arsenitis r 'liij ' 

Sympi aurantii corticis f5l ' 

Aquae anethi q. s. ad f §j ' 
Pro dosi. 

Useful in eczema, psoriasis, etc. 



4| 


1 


' M. 


:er, 


and 


then 


4 


Gm. 




20 " 




4 


" 




32 


" 





ASSAFOETI DA— ASSAFETIDA, 1 

[A gum-re sin on s exudation, obtained by incision from the root of 
Narthex Assqfcetida, U. S. Dose, gr. v-x (.32 to .65 Gm.). 

Officinal Preparations, U. S. 

Mistura Assafoetidae (^iv to Oj). Milk of Assafe- 
tida. Dose, fs>s-j (16 to 32 Gm.). 

Tinetura Assafcetidae (§ij to Oj). Dose, f 5^s— j (2 
to 4 Gm.). 

Pilule Assafoetidae (each gr. iij). Dose, 2 to 4. 

Pilulae Aloes et Assafcetidae (each gr. j^). 

Pilulae Galbani Compositae (assafetida gr. ^). 

Suppositoria Assafcetidae (ea'ch 5 grains, or nixvof 
the tincture). 

Emplastrum Assafoetidae.] 

1 Now usually spelt asafetida. 



172 ORANGE. 

Physiological Action. Therapeutical. 

A good deal of digestive Assafoefida has been used 

disturbance seems to follow and recommended in a con- 

the administration of this siderable variety of affections, 

drug to healthy persons ; but but practically it is now only 

the evidence is too conflicting prescribed in flatulent dys- 

to enable us to lay down any pepsia and in hysteria, where 

exact scheme of its influence its excessively nauseous smell 

on the various functions of and taste are supposed to give 

the body. it an advantage over other 



drugs of the same class. 



AURANTIUM— ORANGE. 

[Aurantii Amari Cortex. The rind of the fruit of 

Citrus vulgaris. 

Aurantii Duleis Cortex. The rind of the fruit of 
Citrus aurantium. 

Aurantii Flores. The flowers of Citrus aurantium 
and Citrus vulgaris. 

Officinal Preparations, U. S. 

Aqua Aurantii Florum. Used as a vehicle. 
Syrupus Aurantii Florum. Used as a vehicle. 
Confeetio Aurantii Cortieis. Used as a vehicle. 
Syrupus Aurantii Cortieis. Used as a vehicle. 
Tinetura Aurantii. Dose, t'3j-ij (4. to 8. Gm.). 

1 Prof. H. C. Wood states that "assafetida is one of the most 
efficient of the so-called antispasmodics, and may "be given to fulfil 
the same indications as valerian in functional spasm, in hysteria, and 
nervousness. It differs from valerian in having a much more de- 
cided action upon the mucous membranes. It is an excellent car- 
minative, and in the form of injection is constantly used for the 
relief of tympanites. It also in small doses increases the appetite 
and affords relief in dyspepsia, with flatulent colic and costiveness, of 
the aged or hysterical. As a stimulating expectorant and anti- 
spasmodic, it is useful in whooping-cough and chronic catarrh. It is 
especially efficient in palliating the latter affection as occurring in 
old people, when the difficulty of breathing is paroxysmally in- 
creased by spasm of the bronchial tubes. In infantile convulsions and 
in severe infantile colic, assafetida enemata (3*ij to §ij of the milk) 
are exceedingly useful and harmless." — Therapeutics, 2d ed., p. 191.] 



OATMEAL. 173 

Infusum Gentianae Compositum. Dose, f 5 ss— i j 
(16. to 64. Gm.). 

Tinetura Cinchonas Composita. Dose, i'5j-ij (4. 
to 8. Gm.). 

Tinetura Gentian® Composita. Dose, f 3j— iv 
(4. to 16. Gm.).] 

Properties. 

The various preparations of orange require no detailed 
comment, for beyond the fact that those made from the rind 
are mildly tonic in virtue of their bitterness, and that the 
syrup and the orange-flower water are agreeable flavoring 
additions to a prescription, we have no evidence of their 
special therapeutic properties, if any exist. [The volatile 
oil of the flowers, obtained by distillation, is called, in com- 
merce, oil of Neroli, and orange-flower water is hence some- 
times termed Neroli water.] 



[AVENGE FARINA—OATMEAL. 

T/ie meal prepared from the seeds of Arena Sativa, U. S. 

Extensively used as an aliment in the form of gruel. It 
is nourishing and slightly laxative. Three varieties are 
met with in this country, the Ohio, the Canadian, and the 
Scotch oatmeal; the latter, being imported, brings a higher 
price, and is considered by some to be better, perhaps solely 
on that account. Thin oatmeal gruel, strained and sweet- 
ened, forms a valuable and popular infant's food. 

The tincture of avena sativa has sedative qualities, and 
has been used with asserted success in the treatment of the 
opium habit.'] 



BALSAMUM PERUVIANUM— BALSAM OF PERU. 

[An empyreumatic liquid balsam obtained from Myrospermum 

Peruiferum, U. S. 

Dose, f"3 5S (2. Gm.) in emulsion.] 

Local Actiox. 

Peruvian balsam tends to It may therefore be used, 

check copious and unhealthy like myrrh, as an application 
secretions. [It has decided to foul and unhealthy sores, 
antiseptic properties.] 

15* 



174 CARBONATE OF BARIUM. 



Constitutional Action. 

Like the other gum bal- It has therefore been pre- 

sams, it acts on the mucous scribed to restrain excessive 

membranes, and more espe- discharges in bronchitis, etc. 
cially on the bronchial tubes. 



BALSAMUM TOLUTANUM— BALSAM OF TOLU. 

[A semi-liquid balsam obtained from Myrospermum Toluifernm, U. S. 

Officinal Preparations, U. S. 

Syrupus Tolutanus. (Tinct. fgij to Oj.) Dose, 
f^ss-j (16. to 32. Gm.). 

Tinetura Tolutana. (gjssinOj.) Dose, f5j (4. Gm.). 
Tinetura Benzoini Composita. (Tolu ^ss in Oj.)] 

This agreeable preparation is almost exclusively used as a 
flavoring addition to cough mixtures, in the form of the syrup. 



[BARII CARBONAS— CARBONATE OF BARIUM. 

Only introduced into the Pharmacopoeia in order to pro- 
vide a source for the — 

Officinal Preparations. 

Barii Chloridum, and 

Liquor Barii Chloridum. Dose, gtt. xxx-1. (2. 
to 2.5 Gm.). 

The symptoms of poisoning by barium chloride or carbon- 
ate are those of an irritant, with vertigo, convulsions, and 
paralysis. Gastric inflammation is found post-mortem. The 
test for baryta is sulphuric acid. Antidotes : sulphate of 
magnesium or sodium, or dilute sulphuric acid, with demul- 
cents, and stomach pump. 

Internal Effects. 

Barium is only used in medicine in the form of liquor 
barii chloridum, which is recommended by Prof. Gross as 
an alterative in scrofula, particularly in cases distinguished 
by a tumid upper lip.] 



DEADLY NIGHTSHADE. 175 



BELLADONNA— DEADLY NIGHTSHADE. 

[Belladonnae Folia. The leaves of Atropa Bella- 
donna, U. S. 

Belladonnas Radix. The root of Atropa Belladonna, 
from plants more than two years old, U. S. 

Officinal Preparations, U. S. 

Tinetura Belladonnas. (From the leaves, gij to Qj.) 
Dose, gtt. x-xx (A')D to 1.30 Gm.). 

Extraetum Belladonnas. (Inspissated juice of the 
leaves.) Dose, gr. ss-ij (.03 to .13 Gm.). 

Extraetum Belladonnas Aleoholieum. (Of the 
leaves.) Dose, gr. ss-ij (.03 to .13 Gm.). 

Extraetum Belladonnas Radicis Fluidum. 
Dose, rti ij (.13 Gm.). 

Emplastrum Belladonnas. (From the root.) 

Unguentum Belladonnas. (From ext. belladonna?, 
5j in 5j.) 

Suppositoria Belladonnas. (From ext. belladonnas 
ale., gr. ss.) 

Atropia. (From the ( Dose, gr. Jq, or hypodermi- 
root.) Really gr. T ^ (.001 to .0005 

Atropias Sulphas. (Gm.). 

Antidotes. 

Chemical. Fresh animal charcoal, tannin, vegetable 
astringents, and the fixed alkalies. 

Physiological. Opium, Calabar bean, tartrate of anti- 
mony and potassium, and pilocarpin. 

Note. — In the treatment of belladonna-poisoning, the irritating 
emetics, such as mustard, ipecacuanha, and sulphate of zinc, 
should be exhibited to remove from the stomach any excess of the 
poison remaining unabsorbed. Apomorphia might be useful 
hypoderruically (gr. J^, repeated). Purgatives containing the 
chemical antidotes should then be given to neutralize any of the 
drug in the intestines. Symptoms of narcotism should be treated 
as they arise, by artificial respiration, douches, counter-irritants, 
and diffusive stimulants. The physiological antidotes, being 
counter-poisons, should be used with the greatest care.] 



176 



DEADLY NIGHTSHADE. 



Local Action. 

Belladonna is used externally, on account of its soothing 
properties, in various forms of neuralgic and rheumatic 
pains, in which cases the liniment, applied either alone, or 
in combination with chloroform liniment, often gives relief. 
It is also a good application in acute rheumatism, placed on 
cotton-wool and thus encasing the swollen and tender joints. 
Belladonna is also useful, as has been specially pointed out 
by Mr. Heath, in boils and abscesses, where the suppurative 
process may be prevented or even arrested by its use. It is 
also a good application to inflamed piles and Jissure of the 
rectum. It is also applied to the skin to check localized 
sweating, to the breast to arrest the secretion of milk, and 
to the neighborhood of the eye to dilate the pupil ; but its 
actions here are so intimately associated with the theory of 
its internal administration, that we will say no more on the 
subject at present. 

Belladonna is very readily absorbed through the unbroken 
cuticle, and symptoms of poisoning have occasionally been 
caused by its local application. 



Internal Administration. 



Physiological Action. 

1. On the Brain — After 
full doses of belladonna, a 
tendency to delirium sets in, 
usually of a joyful character, 
and attended by hallucina- 
tions and spectral illusions. 
Sleep generally follows. 

2. On the Spinal Cord. — 
In frogs this action is very 
decided, for when atropia is 
injected below the skin the 
animal is at first paralyzed, 
lying quite motionless, with 
arrested breathing, which 
period of inaction is suddenly 
interrupted in about from one 



Therapeutical Application. 

1. Belladonna may be 
cautiously used as a hypnotic 
when other remedies fail. 
Ringer records an interesting 
case of acute mania in which 
the heroic dose of gr. j of 
atropia acted well by causing 
sleep. 

2. It is used in some spinal 
affections in accordance with 
the principles of Dr. Brown- 
Sequard, explained under 
another section. 

It is also of value in check- 
ing the tendency which occa- 
sionally exists to nocturnal 
seminal emissions, when these 






DEADLY NIGHTSDZADE. 



177 



to eighteen hours by the oc- 
currence of violent tetanic 
spasms. 

3. Belladonna paralyzes 
the terminal filaments of the 
third nerve supplied to the 
circular or sphincter fibres of 
the iris, and thus allows the 
sympathetic, which rules over 
the radiating fibres, to come 
into unchecked play, and so 
dilate the pupil. At the 
same time we observe a di- 
minution in ocular tension 
and imperfect vision, espe- 
cially for near objects, due to 
paralysis of the power of ac- 
commodation. 

Gubler says that it also 
causes a diminished sensi- 
bility of the cornea and 
retina, with prolonged reten- 
tion of images by the retina. 
He is rather inclined to be- 
lieve that it has some special 
action on the muscular tissue 
of the iris. 



become of exhausting fre- 
quency. 

3. Belladonna, used more 
conveniently in the cleaner 
form of atropia, is in very 
extensive use in eye diseases 
to facilitate ophthalmoscopic 
examinations, and to keep the 
pupil freely dilated in iritis, 
and so lessen the risk of ad- 
hesion of its free margin to 
the lens, with subsequent 
contraction, distortion, and 
impairment of vision. 

It is also used to obviate 
protrusion of the iris through 
any hole in the cornea made 
by ulceration or accident, 
and it forms a soothing ap- 
plication in various painful 
affections. 

To dilate the pupil the liq. 
atropias [Br., gr. iv ad f ^j] 
is now generally used, care 
being taken only to introduce 
a very small drop into the 
eye ; for if a larger quantity 
is applied, the resulting effects 
and inconveniences, more es- 
pecially the paralysis of ac- 
commodation spoiling the eye 
for near work, may last. from 
a week to twelve days, much 
to the annoyance of the pa- 
tient. [Although weaker so- 
lutions take a little longer 
time to dilate the pupil and 
paralyze the accommodation, 
yet these effects are more 
transient and therefore more 
satisfactory to the patient. 
A gr. ^ solution is -strong 



178 



DEADLY NIGHTSHADE, 



4. The action of bella- 
donna on the sympathetic 
nervous system is somewhat 
irregular, and to this is no 
doubt due some at least of 
that action on certain secre- 
tions which we shall shortly 
note more fully. But one 
symptom often observed, 
more especially in children, 
probably proceeds from vaso- 
motor paralysis, and that is 
transient flushing and sweat- 
ing of the face now and then 
following a dose. 

5. The influence of bella- 
donna on the circulation is 
due to another nervous influ- 
ence. Under the use of this 
drug we observe increased 
rapidity and force of cardiac 
action, and this is explained 
by a. paralyzing action which 
it exerts on the terminal in- 
hibitory filaments of the 
pneumogastric nerve distri- 
buted to the intimate struc- 
ture of the heart, as well as 
on the nerve itself, thus dif- 
fering from curare, which 
only affects the trunk of the 
nerve. It is proved by ex- 
periment that the sympathetic 



enough for ordinary use, and 
will dilate the pupil in about 
half an hour after instilla- 
tion.] 

Belladonna being so read- 
ily absorbed, however, dila- 
tation of the pupil will ensue 
on application of the extract 
or liniment for any length of 
time to any part of the body. 



5. Belladonna is an excel- 
lent cardiac tonic, increasing 
the regularity and strength 
of the contractions of the 
heart. 

It is also a very soothing 
remedy in cases of irritable 
palpitation, and the old- 
fashioned belladonna plaster 
is certainly of use in these 
conditions. 



DEADLY NIGHTSHADE. 



179 



nerve supply has the power 
of causing very rapid action 
of the heart; but a rein is 
kept on this, and the proper 
balance of motive force is 
sustained by the pneumogas- 
tric nerve, which inhibits or 
restrains the impetuous action 
of the sympathetic. By 

paralyzing these inhibitory 
filaments, then, belladonna 
hands the heart over to the 
sympathetic, which, without 
rein or drag, runs riot, and 
we accordingly find that ex- 
cessive increase in the heart's 
rapidity follows the injection 
of a moderate quantity of 
atropia. 

Coincident with this we 
get raised arterial tension. 

G. Belladonna contracts 
the small vessels, probably 
not from nervous influence, 
but from a direct action upon 
the unstriped muscular fibres 
surrounding the arterioles. 



6. Dr. Brown-Sequard re- 
commends the use of bella- 
donna in those cases of chro- 
nic inflammation of the spine 
leading to paralysis, where it 
acts well by contracting the 
vessels and diminishing the 
supply of blood to the affected 
part ; and he gives it inter- 
nally, and applies a plaster 
along the spine. 

To this contracting influ- 
ence on the small vessels is 
probably due the effect of 
belladonna in checking local 
inflammatory conditions ; 
[and the power of atropia 
given in small doses fre- 
quently repeated, to relieve 
menorrhagia and haemopty- 
sis. (Dr. Yacke.)] 



180 



DEADLY NIGHTSHADE. 



7. On Respiration Bel- 
ladonna tends to increase the 
rapidity of the breathing by- 
stimulation of the respiratory 
centre. 

8. It has the power of con- 
tracting imstriped muscular 
fibre in other situations than 
the arterial tubes. It proba- 
bly does so both in the blad- 
der and intestines. 



7. Atropia has been re- 
commended as an efficient 
remedy in asthma. 



8. Belladonna is an excel- 
lent remedy for the nocturnal 
incontinence of urine of 
children ; but in order to do 
any good it must be boldly 
pushed, and I have been 
obliged to give as much as 
t'5jss or even i'3ij of the 
tincture [Ph. B.] before suc- 
cess was attained. 1 

From its tonic influence 
on the muscular structures of 
the intestines, it is an excel- 
lent adjunct to purgative pill 
masses, from \ to -J grain 
acting well in combination 
with colocynth ; or, even 



Action on Secretion — 9. 
Salivary. — It checks the sa- 
livary secretion, causing a 
peculiar sensation of dryness 
in the mouth and throat ; and 
this is believed to be due to 
a remarkable selective action 
on the secretory branches 
supplied from the chorda tym- 
pani nerve to the submaxil- 
lary ganglion. 



[ l The Tincture of Belladonna, U. S.. 
strength of the English preparation.] 



given alone with ext. gen- 
tiaiue, it will often secure a 
regular action of the bowels. 

It is also very useful by 
relieving spasm, as in colic, 
and intestinal obstruction has 
occasionally yielded to large 
doses. 

9. Belladonna has been 
used to check excessive sali- 
vation. 



is about 2h times the 



DEADLY NIGHTSHADE. 



181 



10. Cutaneous. — Bella- 
donna most, effectually arrests 
the action of the skin, and 
occasionally under its use a 
vivid red eruption, not unlike 
scarlet lever, breaks out. 



11. It also checks the se- 
cretion of the milk, used 
either locally or internally. 



12. On the solid urinary 
constituents no special action 
has been noted, but it in- 
creases the flow, by raising 
the tension in the glomeruli 
of the Malpighian bodies. 



10. It is an excellent rem- 
edy for undue sweating, whe- 
ther general, as in phthisis 
(as originally recommended 
by Bartholow in I860) 1 or 
rheumatism, or local, as about 
the head of rickety children 
or the feet of some individuals. 
It may be either given in the 
form of succus, extract, or 
tincture, or better by the 
subcutaneous injection of 
atropia. 

11. It is a most valuable 
remedy in cases where in- 
flammation threatens in a 
breast, when the child has 
died or cannot suck, and the 
gland becomes congested 
from retention of its secre- 
tion. Here the external 
application of belladonna 
speedily diminishes the red, 
tense, shining aspect, relieves 
the wearing pain, and arrests 
the milk. 

12. It may therefore be 
recommended as a good di- 
uretic. 



Belladonna is also used under one or two conditions which 
cannot accurately be grouped under any specific heading. 

Thus it has been vaunted in whooping-cough, but after 
careful and repeated trials with large and small doses, I am 
compelled to agree with Dr. Kelly that its action in this dis- 
ease is too uncertain to be of much use. But in certain forms 
of spasmadic cough, simulating pertussis, or when the cough 



[' To Da Costa belongs the credit of having first demonstrated 
the value of atropia in checking excessive sweating in phthisis.] 
16 



182 DEADLY NIGHTSHADE. 

is merely an occasional, loud, clanging bark, I have derived 
much benefit from belladonna. In epilepsy and chorea it 
has been tried, but without marked success. [As a prophy- 
lactic against scarlet fever, belladonna has attained consider- 
able reputation, perhaps undeservedly. It is to be given in 
small doses, continued twice or thrice daily until danger is 
over.] 

The subcutaneous injection of atropia is said by Dr. Anstie 
to be of great service in lumbago, sciatica, and chronic rheu- 
matism, and to be the best of all remedies for pain in the 
pelvic viscera. It has also been recently observed that the 
addition of a little atropia to the ordinary morphia injection 
tends to obviate the distressing faintness, pallor, and nausea 
which occasionally mar the efficacy of the subcutaneous mode 
of administering this valuable drug. Ringer recommends 
its use in irritative dyspepsia, giving from ± to J gr. of the 
extract night and morning, and gradually increasing the 
dose. [A one per cent, solution of atropia, if applied to an 
exposed nerve pulp, is said to relieve toothache immediately.] 

Drawbacks to the Use of Belladonna. 

Poisonous Symptoyns and Antidotes Occasionally the 

use of atropine drops to the eye causes an erysipelatous in- 
flammation about the lids and face, and patients often com- 
plain of the disfigurement and inconvenience arising from a 
widely-dilated pupil. Liebreich (St. Thos. Hosp. Rep., 
vol. vii.) points out that the poisonous symptoms of atropia 
are occasionally developed by its introduction into the eye, 
and that they are due, not so much to absorption by the con- 
junctiva as to the fluid trickling through the lachrymal ducts 
into the nose, throat, and stomach. This may be avoided by 
telling the patient to rinse his throat occasionally. He also 
notes conjunctivitis, erythema, eczema, and peculiar pearly 
granulations on the conjunctivae from the long-continued use 
of these drops. Minor degrees of belladonna poisoning, how- 
ever, need give us no uneasiness. Idiosyncrasy may also 
here be the source of inconvenience, and we may find persons 
affected with dryness of the mouth and throat after very 
small doses. This is always the first indication of the phy 
siological action of belladonna, and is followed by a peculiar 
sensation of thirst and feverishness, without heightened tern- 



DEADLY NIGHTSHADE. 183 

perature, rapid pulse and breathiog, red tongue ; the face 
then flushes, delirium sets in, with great weakness, very hur- 
ried breathing, convulsions, and finally coma, which ends the 
scene. The antidotes are opium, which, within certain 
limits, is antagonistic to belladonna, animal charcoal, the 
fixed alkalies, which destroy its poisonous properties, and 
Calabar bean, which has recently been shown to be the phy- 
siological antidote. A direct physiological antagonism has 
also been shown to exist between atropia, muscarin, and 
jaborandi, or pilocarpine, which stimulate the intracardiac 
inhibitory apparatus, and slow the heart. 

One curious point about belladonna is that, although so 
poisonous to man, its destructive influence is very various on 
other animals. The carnivora are much more readily affected 
by it than the herbivora, many of whom browse on it with 
impunity. Thus a horse has been known to eat eight pounds 
of the leaves without injury ; blackbirds feed freely on the 
berries ; and 15 grains of atropia are required to poison a 
rabbit. 

Dose and Mode of Administration. 

Atropia may be given in phthisical sweating, in pill, in 
doses varying from ? i^ grain (Bartholow) to gr. T V to Jg- 
[Da Costa] ; but it is not very often used internally. 

It is well to note that children take not only without in- 
jury, but with benefit, much larger doses than adults, and, 
whilst I have seen a woman display well-marked physiolo- 
gical symptoms after a few 10-minim doses, I have often 
prescribed 20 minims of the [English] tincture for a child of 
two years without anything of the kind. 

[Asthma Cigarettes. 
R. Belladonnas fol. gr. xcvj ; or (approximately) 6 50 Gin. 

or 3 25 " 

25 " 
5 30 " 
" 500 " 

Macera per horam in vase leviter clauso, cola, et adde — 

Potass, nitrat. 5ij P)ij ; or 10 60 Gm. 

Potass, arsenitis gv 9.i ; " 21 30 " 

M. S. Saturate sheets of bibulous paper in this solution, 
dry and roll them, and use for fumigation as directed. 

Phila. Hosp.-\ 



Belladonnas fol. 


gr 


xcvj ; 


Hyoscyami fol., 






Stramonii fol., aa 


gr- 


xlviij 


Ext. opii 
Tabaci fol. 


gr. 


iv ; 
lxxx : 


Aquae bullientis 


Oj 





184 



BENZOTN. 



BENZOINUM— BENZOIN. 

[A solid balsam obtained from Styrax Benzoin, U. S. 
Officinal Preparations, U. S. 

Ammonii Benzoas. Dose, gr. x-xxx (.65 to 2. Gm.). 

Tinetura Benzoini. Dose, f 5ss-f 5j (2. to 4. Gin.). 

Tinetura Benzoini Composita. Dose, f'5j-ij (4. 
to 8. Gm.). 

Unguentum Benzoini. (Adeps Benzoatus, Br.) 

Acidum Benzoieum. (Enters into Tinetura Opii 
Camphorata.) Dose, gr. x-xxx (.GO to 2 Gm.).] 

Local Action. 
Physiological. 

Tincture of benzoin is a 
stimulant to raw surfaces. 
[Benzoin has the property 
of preventing rancidity in 
ointments, etc., in hot 
weather.] 

Internal Action. 



Therapeutical. 

It is therefore occasionally 
used as an application to foul 
or indolent sores. [The com- 
pound tincture is a useful ap- 
plication to cracked nipples."] 



Benzoin has the stimulat- 
ing influence on mucous 
membranes possessed by most 
of the gum-balsams. During 
its passage through the blood 
it becomes converted into 
hippuric acid, and increases 
in some measure the acidity 
of the urine. 



Benzoin may be prescribed 
with effect in advanced cases 
of bronchitis, and in some 
conditions of chronic irrita- 
tion about the bladder. 

It may be conveniently 
given in the form of the ben- 
zoate of ammonia. 



Gi 



Tinctnrse benzoini composite f 5 V J ! or 24 
Mucilaginis acacise f ^j ; " 32 " 

Syrupi zingiberis f |.ss ; " 16 " 

Aquae mentha? piperita? f §vj ; " 192 " M. 

S apiat unciam unam quarta quaque hora. 

For advanced bronchitis. 

[Benzoic acid, in combination with lime, has been used 
successfully in the albuminuria of pregnancy and in Bright's 
disease, by Dr. A. H. Smith, in doses of sixty to eighty grains 
a day.] 1 



I 1 Proceedings Phila. Co. Med. Soc, vol. iii. p. 106.] 



BISMUTH. 



185 



[OLEUM BERGAMII— OIL OF BERGAMOT. 

The volatile oil obtained from the fruit of Citrus Limetta 
(De Candolle), U. S. 

Used almost exclusively as a perfume.] 



BISMUTHUM— BISMUTH. 

[ Commercial bismuth of good quality, U. S. 
Officinal Preparations, U. S. 

Bismuthi Subearbonas. Dose, gr. xv-xlv (1. to 3. 
Gm.). 

Bismuthi Subnitras. Dose, gr. v-xxx (.32 to 2. 
Gm.;.] 

Local Action. 

PJiysioloyical. Therapeutical. 

Bismuth has no action on It is a good application to 

the unbroken cuticle, but ap- intertrigo, ulceration about 
plied to a raw or mucous sur- 
face, it is sedative and astrin- 



gent. 



the mouth, and as an injection 
in gonorrhoea and leucor- 
rhcea. It has lately been re- 
commended as a snuff to check 
cold in the head, and the li- 
quor has been praised as an 
application to prolapsus ani 
(Cleland). 



Internal Actions and Uses. 



On Digestive Tract. — Bis- 
muth is sedative to the sto- 
mach, and exerts an astrin- 
gent influence over the intes- 
tines, probably in virtue of 
its local effects. [In large 
doses, the subnitrate of bis- 
muth has caused fatal gastro- 
enteritis.] 



Bismuth is one of our most 
valued remedies in many 
forms of dyspepsia, the main 
. indications for its use being 
pain and vomiting. When a 
patient suffers acute pain after 
eating, with or without sick- 
ness, the toninie bein«; clean 
and much flatulence present, 
Ave may give bismuth with 
much confidence: it is also 



16* 



186 BROiMTNE. 

of much service in the vomit- 
ing of drunkards, in pyrosis, 
and in many forms of diar- 
rhoea, more especially that 
met with in children. 

Mode of Elimination. 

Very little bismuth is absorbed, and it is principally thrown 
out of the system by the intestines, to whose secretion it im- 
parts a blackish hue, from the formation of a sulphide. 

Mode of Administration, etc. 

The subnitrate of bismuth, which is the most effective pre- 
paration, may be given simply in powder, either by itself or 
in combination with charcoal or soda; or it maybe given in 
solution with hydrocyanic acid, or infusion of gentian ; mode- 
rately large doses being preferable. 

fy. Bismuthi suhnitratis 3i.i '■> or 8 Gm. 

Mucilaginis acacise i ' §j ; " 32 " 

Acidi hydrocyanici diluti rr\ x-xx ; " 65 " 

Infusi geutianae q. s. ad fgvj ; " 192 " M. 

S. Sumat f §ss ter die. 

I£. Liquoris bismuthi et ammoniae citras [Br.] f 5'v; or 16 Gra 

Syrupi aurantii, 

Infusi calumbse, aa f §v ; " 160 

Misce. Sumat unciam unam ter in die. 

Tlie carbonate and oxide of bismuth are seldom used, but 
an agreeable preparation, less effectual, however, than the 
subnitrate, is known as the liquor bismuthi et ammonia? 
citratis (which contains gr. iij of the oxide to the drachm), 
and lozenges (containing each gr. ij of the subnitrate) are 
also included in the British Pharmacopoeia. 



BROMINIUM— BROMINE. 

[A liquid, non-metallic element, obtained from sea-water. 

Dose, gtt. ij-iij (.13 to .20 Gm.), largely diluted with 
water. 

Officinal Preparations, U. S. 

Ammonii Bromidum. Dose, gr. xx-xxx (1.30 to 2. 
Gm.). 

Potassii Bromidum. Dose, gr. x-3j (.So to 4. Gm.). 



BUCHU. 



187 



Antidote. 

Ammonia, followed by the customary treatment for irri- 
tant poisons.] 

Bromine has been used as a lotion by Dr. Routh and 
others [and in olive oil (rt^x to |j) it is said to be a specific 
for the eruption of poison-ivy, rhus toxicodendron']. 

Bromine being never used to any extent in medicine, we 
shall consider its properties under Bromide of Potassium. 

[Bromine is a valuable caustic, and is sometimes used in 
gynecology as an application to the uterus. It is said that 
its mixture with glycerine and alcohol is liable to explode. It 
is useful in hospital gangrene both as a caustic, and in dilute 
solution as an antiseptic wash. Used internally, it resembles 
iodine in its effects as an alterant.] 



BUCHU— BUCHU. 

\_The leaves of Barosma Crenata and other species of Barosma, U. S. 
Officinal PPtEPAKATioxs, U. S. 

Extractum Buehu Fluidum. Dose, f 3-ss— j (2. to 
4. Gin.). 

Infusum Buehu (f $j to Oj). Dose, f ^j-ij (32. to 
54. Gra.).] 



Physiological Action. 

The physiological action 
of buehu is principally if not 
entirely expended on the 
mucous membrane of the 
genito-urinary organs. It is 
probable that the volatile oil 
which it contains, being rap- 
idly taken into the blood and 
as rapidly excreted by the 
kidneys, acts locally through 
the urine on the lining mem- 
brane of the bladder and 
urethra. [It is also, to some 
extent, diaphoretic] 

The urine is impregnated 



Therapeutical. 

Buehu has long been val- 
ued by surgeons as a useful 
remedy in chronic catarrh of 
the bladder and the various 
mucous discharges from the 
genito-urinary organs de- 
pending on a relaxed condi- 
tion of the affected parts. 
[It is largely employed in 
the treatment of subacute 
or chronic gonorrhoea, re- 
sembling turpentine in its 
effects, although far less stim- 
ulating. In incontinence or 
retention of urine, depend- 



188 CADMIUM — COFFEE. 

with the peculiar odor of the ing upon want of tone in the 
drug, and is perhaps slightly bladder, it is a most useful 
increased in quantity. agent.] 



CADMIUM— CADMIUM. 

Officinal Preparation. 
Cadmii Sulphas. Used externally. 

The sulphate of cadmium strongly resembles the cor- 
responding zinc salt in its properties, and is occasionally 
employed as an astringent collyrium (gr. i-iv to rose-water 
f'5J). The iodide of cadmium is officinal in the British 
Pharmacopoeia, but is only used in the form of unguentum. 
cadmii iodidi [Br., gr. lxij to 5J] in some cases of skin dis- 
ease [making an admirable substitute for the iodide of lead]. 



CAFFEA— COFFEE. 

[ The seed of Caffea Arabica, U. S ] 

Tea, coffee, guarana, and coca, substances containing the 
same alkaloid, caffeine, have much the same effect. 

CAFFEINE 

is a very active substance, causing at first increase, but later 
diminution, of the reflex functions of the cord, with nervous 
convulsions and muscular rigidity, the motor nerves not 
being affected. The heart's action is at first accelerated, but 
afterwards retarded. The excretion of urea is lessened. 
The frequent and prolonged use of tea and coffee causes, in 
some persons, a variety of nervous sensations, sleeplessness, 
numbness and tingling of the extremities, with irritability 
of the heart ; and there is no doubt that much loss of appe- 
tite and flatulent dyspepsia originate in the habit of drinking 
tea shortly before or after meals. The invigorating and re- 
storative effects of tea and coffee are well known, and valued 
by persons undergoing much bodily fatigue. The therapeutic 
indications for tea and coffee are almost restricted to the 
administration of the latter substance in cases of opium- 
poisoning, but citrate of caffeine in 2-grain doses has been 
recently highly recommended in nervous and sick headache. 
It is also in doses of 3 grains and upwards an efficient diu- 



OIL OF CAJUPUT — CALCIUM. 189 

retic, increasing the force and rapidity of the heart, and aug- 
menting the blood pressure. 

Guarana in gramme doses has been found a useful remedy 
for migraine or sick headache, and the chewed leaves of the 
coca plant have been highly recommended by Sir R. Chris- 
tison and others as a nervine and muscular stimulant. 
Although the respected baronet found great benefit from this 
plant during severe exertion, Weston, the well-known pedes- 
trian, gives his opinion as tending quite to the opposite con- 
clusion. 



[OLEUM CAJUPUTI— OIL OF CAJUPUT. 

The volatile oil obtained from the leaves of Melaleuca Cajuputi 
(Roxburgh, Trans. Lond. Jfedico-Botan. Socy.), U. S. 

Cajuput oil is highly prized in the East Indies as a stimu- 
lant carminative. The ordinary dose is gtt. ij-v (.12 to .32 
Gm.), but it has been given with great success in the col- 
lapse of cholera, in doses of gtt. xv to f 5j (1. to 4. Gm.). It 
is also used as a rubefacient and counter-irritant, diluted 
with olive oil. Like other oils of this class, it relieves tooth- 
ache when introduced into a carious tooth.] 



CALCIUM—CALCIUM. 

TCaleii Chloridum — Chloride of calcium prepared by 
fusion, U. S. 

Caleii Hypophosphis— Hypophosphite of lime. Dose, 
gr. x-xxx (.65 to 2. Gm.). 

Calx — Lime recently prepared by calcination, U. S. 

Calx Chlorinata — A compound resulting from the 
action of chlorine on the hydrate of calcium and containing 
at least '2b per cent, of chlorine, U. S. 

Officinal Preparations, U. S. 

Caleis Hydras. Used in pharmacy. 

Caleii Carbonas Pra^cipitata. Dose, gr. xx-5j 
(1.30 to 4. Gm.). 

Caleii Phosphas Prsecipitata. Dose, gr. x-xxx 
(.65 to 2. Gm.). 

Creta Prseparata. Dose, gr. x-xv (.65 to 1. Gm.). 



190 CALCIUM. 

Hydrargyrum cum Greta (mercury 3 pts., chalk 
5 pts.). Dose, gr. v-xxx (.32 to 2. Gm.). 

Troehisci Cretan. 

Mistura Cretan. Dose, fgss (16. Gm.). 

Testa Pra^parata. Dose, gr. x-xv (.65 to 1. Gm.). 

Liquor Caleii Chloridi. Dose, nrxxx (2. Gm.). 

Liquor Caleis (lime-water). Dose, f'3j-iv (4. to 
16. Gm.) 

Linimentum Caleis (lime-water f^viij, linseed oil 
fSvij). 

Potassa cum Calee (Vienna Paste). Used as a 
caustic. 

Also used in the preparation of iEther Fortior, Ammonii 
Valerianae, Aqua Ammoniac, Liquor Potassa?, Liquor Soda?, 
Liquor Soda? Chlorinate, Quiniae Sulphas, Santoninum, 
Spiritns Ammonia?, Strychnia, and Sulphur Praecipitatum.] 

Local Action. 

Physiological. Therapeutical. 

Some of the preparations Lime is used as a soothing 

of lime, used externally, are application to burns, as in 

sedative or soothing; others the linimentum caleis; and 

are astringent. lime-water makes a good 

injection for leucorrhcea, or 
enema for the destruction of 
thread-worms. 

[In croup and diphtheria, 
great relief is afforded by 
breathing the vapor of slaking 
lime, or simply atomized lime- 
water.] 

Internal Uses. 

Lime, taken internally, It is therefore used with 

neutralizes acid secretions, benefit in some forms of dys- 
and has astringent proper- pepsia and in diarrhoea, 
ties. liquor caleis being the most 

generally employed prepara- 
tion. Lime-water is also of 
great service in preventing 
the curdling which often 
causes milk to disagree with 
patients of weak digestion. 



COLUMBO. 191 

Chalk is more astringent than lime, and is an excellent 
remedy, either alone or in combination with opium, for 
diarrhoea. 

Chloride of calcium has been highly praised as a remedy 
for various forms of scrofula. [The close of fused chloride 
of lime (not calx chlorinata) is gr. x-xx (.65 to 1.30 Gin.), 
but it is rarely prescribed.] 

Phosphate of lime has been highly praised by Ringer in 
doses of gr. j to ij (.00 to .12 Gm.) in rickets, where it acts 
by improving the general nutrition of the system, and sup- 
plying structural elements in which the growing bones of 
badly nourished children are often deficient ; the best time for 
administration being after the cessation of the acute period, 
when all tenderness lias subsided. It is also of service in 
anaemia, general debility, tubercular diarrhoea, etc., and the 
dose must never exceed gr. j to ij, more than which will not 
be absorbed. [The hypophosphite of lime has been highly 
recommended in consumption. 

The sulphide of lime is considered to be very useful in the 
furuncular diathesis, when boils appear in crops. Ringer 
gives gr. y 1 ^ every hour, at first ; subsequently a larger dose 
may be given less frequently. It is also used in scrofula 
and chronic ulcers.] 



CALUMBA— COLUMBO. 

[The root of Jateorrhiza pahnata (Miers), Cocculus pahnatus (De 
Candolle) ; and Jateorrhiza Calumba {Miers), Cocculus pahnatus 
tWaUich Catal. non D. C), U. S. 

Officinal PpvEparatioxs, U. S. 

Extractum Calumba? Fluidum. Dose, tt^xv-xxx 
(1. to 2. Gm.). 

Infusum Calumbae (root sss to Oj). Dose, fgj-ij 
(16. to 32. Gm.). 

Tinetura Calumbae (root 51J to Oj). Dose, f£j-ij 
(4. to 8. Gm.).] 

Local Action. 
Calumba has no local action. 



192 



CAMPHOR. 



Constitutional Action. 



Physiological. 

On the Digestive Func- 
tions. — Like all bitter tonics, 
calumba stimulates the appe- 
tite, and increases slightly 
the secretion of saliva and 



Therapeutical. 

Calumba is a good tonic 
in deficient appetite from in- 
digestion or simple want of 
tone, in various dyspeptic 
conditions, and in most en- 



the gastric juice. It is lighter feebled states of the consti- 
tution, from whatever cause 
they may arise. [As it does 
not contain tannic acid, it 
may be given in combination 
with iron.] 



and more agreeable than 
some others of the class, and 
has been believed to have 
sedative properties, in virtue 
of which it may be bene- 
ficially given in sickness and 
vomiting ; but of this we 
have been unable to obtain 
reliable evidence. 



Mode of Administration. 

Columbo is usually given in combination either with iron, 
with alkalies, or with other tonics. Thus : — 

T^. Ferri et potassii tartratis £iss ; 

Potassii bicarbonatis 5U \ 

Syrupi hemidesmi [Br.] f §j ; 

Infusi calumbse f § vij ; 

Misce, fiat mistura. Capiat unciam unam bis in die. 

fy. Pulveris calurnbae gr. x ; or 

Sodii bicarb. ' gr. xx ; " 1 

Pulv. rhei gr. v ; " 

Pulv. zingiberis gr. x ; " 

M. Fiat pulvis bis in die sumendus ante cibum 

A useful powder in some forms of dyspepsia. 



6 


Gm. 


8 


a 


32 


a 


224 


a 


n die. 


65 Gm. 


30 " 


32 " 


65 


c< 



CAMPHORA— CAMPHOR. 

[A peculiar, concrete substance, derived from Camplwra officinarum, 
and purified by sublimation, U. S. 

Dose, in substance, gr. i-ij (.00 to .13 Gm.). 

Oleum Camphorae (Oil of Camphor). Dose, gtt. 
ij-iij (.13 to .20 Gm.). 



CAMPHOR. 193 

Officinal Preparations, U. S. 

Aqua Cam.ph.ora3 (3j to Oj). Dose, fSj-foti (4. to 
64. Gm.). 

Linimentum Camphorae (camphor 1 pt., olive oil 
6 pts ). 

Linimentum Saponis. 

Mistura Chloroformi (chloroform fgss, camphor 5i 

in f'.lvj). 

Spiritus Camphorae (3 ij to Oj). Dose, n^xv to f3j 
(1. to 4. Gm.). 

Tinetura Opii Camphorata (Paregoric). Dose. 
f*ss (16. Gm.). 

Ceratum Plumbi Subaeetatis (Goulard's Cerate). 

Antidotes. 
Opium and stimulants.] 

Local Effects. 
Physiological. Therapeutical. 

Camphor has some rube- Camphor forms an ingre- 

facient properties, reddening dient of most of the lini- 
and irritating the skin. ments in common use. 

Internal Action. 

1. Brain and Nervous 1. Camphor is not used 

System Camphor in large in large doses on account of 

closes causes a good deal of its action on the nervous sys- 

giddiness and confusion of tem, and the results of the 

ideas, even amounting in few experimenters who have 

some cases to delirium. been bold enough to try the 

Muscular weakness is at effects of large doses on them- 

first observed, but this rap- selves have not been of a 

idly gives way to violent epi- very encouraging nature. [It 

leptiform convulsions and is moderately stimulating and 

almost maniacal excitement, diaphoretic, and possesses un- 

In frogs, well-marked lower- doubted anodyne and narcotic 

ing of the reflex irritability influence. In the spasmodic 

of the spinal cord has been and nervous complaints of 

observed. women, camphor is exten- 
sively employed.] 
17 



194 



CAMPHOR. 



2. Circulation. — In small 
doses camphor seems to stim- 
ulate the heart's action, but 
after the administration of 
larger quantities great car- 
diac prostration has been ob- 
served by Dr. Geo. Johnson 
and others. 



3. Respiration and Tem- 
perature No influence on 

the respiration is noted, but 
there is a marked lowering 
of temperature. 

4. Digestive and Secreting 

Organs In large doses, 

some irritation'of the gastro- 
intestinal mucous membrane 
has been observed, with dia- 
phoresis, and the sexual ap- 
petite seems to be diminished. 



2. Camphor lias been found 
of service in the early stages 
of coryza, but must be here 
used "with caution, as the 
homoeopathic tincture, which 
is sometimes prescribed out- 
side of the regular profession, 
is now known to be a very 
strong preparation, and Dr. 
Geo. Johnson and others have 
described cases in which ex- 
cessive weakness and faint- 
ness, with great cardiac and 
muscular prostration, fol- 
lowed doses of from 15 to 
20 minims [and several fatal 
cases of poisoning by it have 
been reported]. 



4. Camphor is said to be 
a good remedy in summer 
diarrhiea. 



It is a popular antidote in 
chordee. 



Administration. 

The bromide or monobromide of camphor has been highly 
recommended in nervous palpitation and irritation of the 
genito-urinary organs, and it also has the power of lowering 
the bodily temperature. 

[The combination of camphor with opium and acid forms 
an exceedingly useful mixture for the treatment of acute 
dysentery, following a chilling of the general cutaneous 
surface, often noticed during summer. Opium, camphor, and 
aromatics form the basis of most of the cholera mixtures dis- 
pensed by druggists. Hope's Camphor Mixture is one of the 
best known of these nostrums, and is often of great service. 



CANELLA — INDIAN HEMP. 195 



Hope's Camphob Mixture. 

3.. .Acid, nitrosi "i : or 4 Gm. 

Tinct. opii deod. Vf[xl 5 " 2 60 " 

Aqua? camphone q. s. ad §viij ; " 256 " M. 

Dose, 5 part, after each evacuation.] 



[CANELLA— CANELLA. 
The bark of Canella alba, U. S. 
Officinal Preparations, U. S. 

Pulvis Aloes et Canellae (aloes 12, canella 3 parts). 
Do<-. gr. x-xx (.60 to 1.30 Gm.). 

Vinum Rhei (rhubarb §ij, canella 5j> to Oj). Dose, 
f3j-iv (4. to 1G. Gm.). ' 

Uses. 

Canella is an aromatic tonic, but is rarely prescribed alone. 
It contains no tannin, and may be given with a chalybeate. 
The powder of aloes and canella is a popular remedy for 
amenorrhcea under the title of Hiera Picra.] 



[CANNA— CANNA. 

The feada from the rhizome of an undetermined species of Carina, U. S. 

Canna-starch may be used like arrowroot as a bland 
form of nourishment for invalids.] 

[CANNABIS AMERICANA—AMERICAN HEMP. 

The flowering tops of Cannabis Sativa, cultivated in North 
America, U. S. 

Officinal Preparation, U. S. 

Extractum Cannabis Americana?. Dose, gr. \ 
to i (.015 to .03 Gm.).] 



CANNABIS INDICA— INDIAN HEMP. 

\_Tlie flowering lops of the female plant of Cannabis Saliva, 
variety Indica, U. S. 

Officinal Preparations, U. S. 

Extractum Cannabis Indicse. Dose, gr. \ (.03 
Gm.). 



196 



INDTAN HEMP. 



Tinetura Cannabis (gr. iij ad f 5j). Dose, gtt. x-xx 
(.65 to 1.30 Gm.).] 

Local Action. 
Indian hemp is never used locally. 

Internal Actions. 



Physiological. 
1. On Brain and Nervous 
System. — Indian hemp, like 
opium, possesses a double 
exciting and sedative action, 
the brain being stimulated 
into pleasant exhilaration be- 
fore sleep sets in. This pre- 
liminary effect, however, is 
more powerful and lasting 
than in the case of opium, 
and the subsequent condition 
of slumber is usually dis- 
turbed by dreams and spec- 
tral illusions. Various au- 
thors have given graphic de- 
scriptions of the intellectual 
disturbance produced by tills 
drug, dwelling more especi- 
ally on a peculiar feeling of 
double consciousness, leading 
on, in some cases, to partial 
catalepsy. 

We also find indications 
of some special affection of 
the sensory nerves, a marked 
degree of numbness and ting- 
ling, ushering in cutaneous 
anaesthesia and diminution of 
the muscular sense. 

2. Circulation Some in- 
creased rapidity of pulse has 
been observed during the ac- 
tion of Indian hemp ; but it 
is probable that this is only 
due to the condition of nerv- 



Therapeutical. 
1. Indian hemp may be 
used as a narcotic when other 
remedies fail ; but its action 
is so uncertain and irregular, 
and the difficulty of procur- 
ing reliable preparations so 
great, that our present know- 
ledge does not enable us to 
lay down any practical rules 
for its employment. Dr. 
Clouston, however, has ob- 
tained valuable assistance in 
acute mania by prescribing 
the tincture in combination 
with bromide of potassium. 
Although later experience has 
not confirmed the pretensions 
of those who formerly vaunted 
Indian hemp as a cure for hy- 
drophobia, chorea, tetanus, 
and allied nervous ailments, 
we may sometimes produce 
good results in neuralgia and 
migraine by its cautious use. 



CANTIIARIDES. 19' 

ous excitement which we have 
just described. 

3. Digestive System. — No 
special effect seems to be pro- 
duced on the stomach or in- 
testinal canal, and the absence 
of constipation following its 
use gives Indian hemp one 
advantage over opium. 

Dose and Modi: of Administration. 

R:. Tinctura? cannabis Indica? 

Mucilaginis acacias 

Syrupi zingiberis 

Aqua? mentha? piperita? 
Misce, fiat mistura. Capiat unciam unam quarta quaque 
bora. 

In neuralgia, etc. 



f 3.] : 


or 


4 Gm. 




" 


32 " 


f ^ss ; 


" 


16 " 


f5vj 


c< 


192 " 



CANTHARIS— SPANISH FLY. 

[Caniluaris vesicatoria, Lytta vesicatoria (Fabricius), U. S. 

Officinal Preparations, U. S. 

Tinctura Cantharidis. Dose n^iij-v (.20 to .32 
Gm.). 

Ceratum Cantharidis. (For spreading blisters.) 
Ceratum Extraeti Cantharidis. 
Charta Cantharidis. (Blistering paper.) 
Collodium cum Cantharide. 
Linimentum Cantharidis. 
Emplastrum Pieis cum Cantharide. 
Unguentum Cantharidis (5u in §j). 

Poisoning. 

Cantliarides is an acrid and corroding animal poison. Its 
prominent symptoms are a burning sensation in the throat ; 
violent pain in the stomach and bowels; nausea, vomiting, 
and purging — the dejections being frequently bloody and puru- 
lent ; great heat and irritation of the urinary organs, some- 
times the most painful -priapism ; pulse quick and hard ; and 
convulsions, tetanus, delirium and syncope. 

The morbid appearances are principally inflammation and 
erosion of the stomach. If in substance, fragments of the 

17* 



198 



CANTHARIDES. 



flies, with their characteristic green, shining appearance, 
will be found adhering to the mucous coat, or mixed with 
the contents of the stomach ; there are also marks of inflam- 
mation in the intestines and urinary organs, but these are 
most evident when death does not soon follow the ingestion 
of the poison. 

Treatment. — The promotion of vomiting by means of 
warm demulcents; copious dilution, bleeding, the warm bath, 
opiate frictions, enemata of mutton broth, laudanum, etc. 
Camphor, though not an antidote, alleviates some of the 
most distressing symptoms. 

Antidote. 

There is no antidote for cantharides.] 

External Actions. 



Physiological. 
The first effect of the ap- 
plication of cantharides to the 
skin is tingling and smarting, 
speedily followed by vivid 
redness and severe burning 
pain. To this succeeds the 
formation of large blebs con- 
taining a watery fluid rich in 
albumen and fibrine ; and if 
the blister be allowed to re- 
main for any lengthened pe- 
riod in contact with the skin, 
ulceration and sloughing may 
supervene. It has been found 
that the moderate counter- 
irritant action of cantharides 
causes the copious exudation 
of white blood-corpuscles into 
the subcutaneous areolar tis- 
sue, with engorgement of the 
more superficial structures 
underlying the skin, whilst 
the deeper strata look pale, 
anaemic, and flabby ; the lungs 
even being affected in this 
way. It has also been shown 



Therapeutical. 
Blisters are used to fulfil 
the following indications : — 

1. To relieve pain. There 
can be no doubt that blisters 
frequently check pain most 
effectually, as in subacute 
pleurisy, pleurodynia, gas- 
tralgia, sciatica, and neural- 
gia, it being important that 
in this last-named affection 
the counter-irritant should be 
placed as near as possible to 
the root of the affected nerve. 

2. To check inflammatory 
conditions. There is no doubt 
that some local inflammations 
may be checked by blistering 
a neighboring vascular area. 
Thus, in iritis and some other 
inflammatory affections of the 
eye, benefit may be procured 
in this way ; and in acute 
rheumatism blisters applied 
immediately above the in- 
flamed joints rapidly remove 
pain and swelling. 



CANTHARIDES. 



199 



that the irritant action of can- 
tharides may penetr a t e 
through the skin, and cause 
redness and inflammation of 
the pleura and peritoneum. 
The first constitutional effect 
of a blister is a slight eleva- 
tion and subsequent depres- 
sion of the temperature, with 
weakening of the action of 
the heart. 

It not uncommonly hap- 
pens that cantharides maybe 
absorbed through the skin, 
and cause kidney irritation. 

[Blisters are spread with 
the cerate and not with the 
ointment of cantharides ; the 
prescription being in this 
form : — 

R. Cerati cantharidis q. s. 

Ft. emplastrum 2x- in. 
S. Apply as directed. 

A better method of making 
blisters however is mentioned 
at the foot of the next page.] 



On this principle, also, Mr. 
F. Jordan recommends his 
iodine treatment of localized 
surgical affections already re- 
ferred to. 

In how far inflammations 
of internal organs may thus 
be treated with advantage is 
a somewhat open question ; 
for although the withdrawal 
of blood from the deeper 
structures might theoretically 
be considered beneficial, it is 
practically found that the 
pain and annoyance of blis- 
ters add to the feverish dis- 
comfort of the victims of 
acute disorders. 

3. To promote absorption. 
Blisters are supposed to aid 
the absorption of effused pro- 
ducts, fluid or solid, and are 
therefore much used in tho- 
racic dropsy, either pleural 
or pericardial, the latter 
stages of pneumonia, chronic 
joint-disease, etc. 

4. To stimulate and alter 
vascular or nervous functions, 
etc. Blisters may be employed 
to rouse patients from the stu- 
por of typhus, or narcotic 
poisoning, or various brain 
ajfecfions, to check obstinate 
vomiting, and under various 
other conditions laid down in 
works on practical medicine. 



Internal Action. 

Physiological. Therapeutical. 

Cantharides is a gastro- Cantharides is not much 

itestinal irritant, and also a used internally, on account of 



200 



CANTHARIDES. 



renal stimulant and diuretic, 
causing an increased flow of 
urine, but frequently giving 
rise to a good deal of stran- 
gury, with painful, frequent, 
and difficult micturition, and 
bloody urine. This irritation 
may spread by sympathy to 
other allied organs, and uter- 
ine excitement on the one 
side, or excess of venereal 
appetite with chordee and 
seminal emissions on the 
other, may follow the admin- 
istration of larsre doses. 1 



its irritating properties. It 
is, however, occasionally pre- 
scribed in pyelitis and some 
chronic affections of the kid- 
ney, and in chronic diseases 
of the spine. 

Some authorities also have 
praised it highly in psoriasis. 
It has also been used for the 
purpose of procuringabortion, 
audit possesses einmenagogue 
properties. 



Cautions. Mode of Administration. 

We must use blisters with caution under the following 
circumstances : — 

In the aged, infirm, or very young, where troublesome 
ulceration is apt to ensue. 

In acute inflammatory conditions, and more especially 
those of the kidney. 

To cicatricial tissue, or to parts deprived of some of their 
vitality by the withdrawal of nervous influence, as in para- 
plegia. 

Blisters are usually kept on from ten to twenty hours, but 
we may well limit the period to six or eight hours, and de- 
velop the blebs by a subsequent poultice. When the desired 
effect has been produced, let out the watery fluid, and apply 
a thick layer of cotton-wool. 

[A good method of making blisters without pain is to ap- 
ply collodium cum cantharide, or blistering collodion, over 
the desired area. If well applied it is efficient, prompt, and 
painless, and does not cause strangury. No poulticing is 
needed, as a rule, the application of a piece of waxed paper 
or oiled silk to protect it from the air only being employed. 
The epidermis over the blister should not be removed.] 

1 [The tincture of cantharides, U. S. P., is more than twice the 
strength of the English preparation.] 



CAPSICUM — CARBON. 201 

CAPSICUM— CAPSICUM. 

[Syn. Cayenne and African Pepper. 

The fruit of Capsicum annuuni Capsicum fasti giatum (Blum), 
and other species of Capsicum, U. S. 

Officinal Preparations, U. S. 

Infusum Capsici. Dose, fgss (16. 6m.). 
Oleo-Resina Capsici. Dose, gtt. j (.06 Gm.). 
Tinetura Capsici. Dose, fjj-ij (4. to 8. Gm.).] 

This is a topical stimulant to the mucous membranes, ex- 
citing the appetite in small doses, but in larger quantities 
causing gastro-enteritis. In some forms of sore throat, as in 
the early stage of tonsillitis, or in simple relaxation of the 
mucous membrane, it forms a useful addition to a gargle as 
infusum capsici. 

Recently it has been highly praised by Dr. Lyons, of 
Dublin, in ten-minim doses of the tincture before meals, for 
the relief of the nausea, depression, and drink-craving of 
the confirmed dipsomaniac. 

R. Tin cturae capsici nix ; or 160 Gm. 

Tinctnrse nucis vomicse \\x ; " 60 " 

Acidi nitrici diluti n^xx " 130 " 

Aquas q. s. ad f^j "32 " M. 

Fiat haustus ter in die sumendus. 

Useful in drink-cravins. 



CARBO— CARBON. 

[Carbo Animalis — Charcoal prepared from bone, U. S. 

Used in preparing Cinchonise Sulphas, Morphia, Quinise 
Sulphas, and Santoninum. 

Carbo Ligni — Charcoal prepared from wood, U. S. 
Used in preparing Acidum Sulphurosum and Potassii 
Iodidum. 

Officinal Preparation. 

Carbo Animalis Purificatus. 

Used in making Acidum Gallicum, Digitalinum, Strych- 
nia,, and Veratria.] 



202 



CARBON. 



Local Actions. 



Physiological. 

Charcoal has no purely 
local action on any tissue 
with which it is brought in 
contact, and as it is quite in- 
soluble it can exert no gene- 
ral influence on the functions 
of the body. It is therefore 
simply a mechanical agent 
and acts in virtue of the fol- 
lowing properties 

1. It not only freely ab- 
sorbs gases within its pores, 
but oxidizes and destroys 
those of an offensive and in- 
jurious nature, as sulphuretted 
hydrogen ; and further, it 
also deodorizes, by oxidation, 
and destroys organic impuri- 
ties of all kinds, thus decolor- 
izing solutions which contain 
them. 



Therapeutical. 

1. In virtue of its absorb- 
ing powers, charcoal is used 
in many of those cases of dys- 
pepsia where large quantities 
of gas are formed by prema- 
ture decomposition of the 
food, and where much pain, 
nausea, and want of appetite 
are experienced by the pa- 
tient. In consumption and 
many chronic stomach dis- 
orders, charcoal acts well by 
relieving the flatulence which 
is often the chief discomfort 
of the sufferer. Charcoal is 
also an excellent deodorizer 
and antiseptic, and is used 
for these purposes in the con- 
struction of filters, contact for 
four months being sufficient 
to purify the foulest and most 
deeply stained waters; and if 
the organic matter present 
does not exceed from 1 to 2 
grains per gallon the charcoal 
will permanently retain its 
cleansing properties. It may 
also be of great service in ab- 
sorbing and destroying offen- 
sive effluvia in the neighbor- 
hood of sewers or drains, and 
it used to be a fashionable ap- 
plication to unhealthy ulcers; 
but cleaner and equally effec- 
tual antiseptics have now en- 
tirely displaced it from popu- 
lar favor. 

It is also occasionally em- 
ployed in the formation of 



CARDAMOM. 203 

respirators and as an adjunct 
to tooth powders, and Dr. 
Thorowgood advises its pre- 
scription in teaspoonful doses 
in bleeding piles. 
2. Animal charcoal pos- 2. If we are called very 
sesses the power of render- early to a case of jioisoning 
ing various vegetable poisons by opium, aconite, strychnia, 
inert by placing them in a or other vegetable poison, we 
form of combination beyond may hope to do some good by 
the absorptive powers of the charcoal, provided that ab- 
stomach. sorption of the poisonous 

agent has not yet taken place 
to any extent. 

Mode of Administration. 

As a medicinal agent vegetable charcoal alone is used, 
and may be given in doses of from a tea- to a table-spoonful, 
great care being taken to insure perfect freshness, as its ab- 
sorptive powers are seriously impaired by keeping. It may 
be combined effectively with bismuth, or given in sandwich 
form between bread and butter, or moistened with spirit in 
a wineglass before suspension by water; but in any case its 
unsightly appearance, gritty consistence, and insolubility in- 
terfere with its prescription in elegant form, and we may 
advise our patients with advantage to make use of the varie- 
ties of biscuits, lozenges, and capsules, which the ingenuity 
of chemists have devised. 

As an antidote, animal charcoal must be given in con- 
siderable doses, as it is calculated that half an ounce is 
required to neutralize one grain of vegetable alkaloid. 
As an antiseptic it may be placed in shallow pans close to 
the outlet of drain or sewer ventilating shaft. 



CARDAMOMUM—CAPxDAMOM. 

[The fruit of Ehttaria Cardamomum, U. S. 

Officinal Preparations, U. S. 

Extraetum Colocynthidis Compositum. Dose, 
gr. v-xxx (.30 to 2. 6m.). 

Pulvis Aromaticus. Dose, gr. x-xxx (.Go to 2. 
Gm.). 



204 CARAWAY — CLOVES. 

Tinetura Cardamomi. Dose, f 5.i-ij (4. to 8. Gra.). 

Tinetura Cardamomi Composita. Dose, f 3j-»v 
(4. to 16. Gra.). 

Tinetura Gentian© Composita. Dose, f 3j-ij (4. 
to 8. Gm.). 

Tinetura Rhei. Dose, f3j-iv (4. to 16. Gm.). 

Vinum Aloes. Dose, f'5j-t'3j (4. to 32. Gra.).] 

This is an agreeable stimulant and flavoring adjunct. 
[CARUM— CARAWAY. 

The fruit of Carum Carui, U. S. 
Officinal Preparations, U. S. 

Oleum Cari. Dose, gtt. j-x (.06 to .65 Gm.). 
Tinetura Cardamomi Composita. Dose, f 5j— 
f^ss (4. to 16. Gm.). 

Caraway is an agreeable aromatic, used as a stomachic, 
or to prevent the griping of other medicines. The oil is 
most frequently employed, but an infusion may be made 
containing 5lj to Oj.] 



CARYOPHYLLUS— CLOVES. 

[ The unexpended flowers of Caryophyllus Aromaticus, U. S. 

Officinal Preparations, U. S. 

Infusum Caryophylli (3ij to Oj). Dose, fgij (64. 
Gm.). 

Oleum Caryophilli. Dose, gtt. ij-vj (.12 to .40 Gm.). 

Cloves also enter into Spiritus Lavandulae Compositus, 
Syrupus Rhei Aromaticus, and Vinum Opii. 

Cloves are a stimulating stomachic, and may be given in 
substance in doses of gr. v-x.] Cloves, pimento, and oil of 
cajuput are carminative and perhaps antispasmodic, and may 
be useful in flatulent colic, hysteria, etc., more especially as 
adjuncts to other remedies. 

[Clove-tea is a domestic remedy for dysmenorrhea and 
colic. The oil is frequently used to relieve tooth-ache, a 
piece of cotton tinctured with it being placed in the cavity. 
Spice plasters are sometimes employed to relieve pain, a good 
formula being : ginger, cloves, cinnamon, and black pepper, 
in powder, eacli an ounce ; tincture of ginger half an ounce ; 
honey enough to make a stiff paste.] 



CASCARILLA — CASTOR. 205 

CASCARILLA— CASCARILLA. 

[ The bark of Croton Eluteria, U. S. 
[Officinal Preparations, U. S. 
Infusum Casearillae. Dose, a wineglassful.] 
Cascarilla is a light and agreeable tonic. 



[CASSIA FISTULA—PURGING CASSIA. 

The fruit of Cassia Fistula, U. S. 

Cassia pulp is laxative in doses of one or two drachms, 
but is rarely used except in the officinal combination, Con- 
feetio Sennas, which is a favorite remedy against constipation 
in pregnancy. Dose, 3j-ij (4. to 8. Gm.) ] 



[CASSIA MARILANDICA— AMERICAN SENNA. 

The leaflets of Cassia Marilandica, U. S. 

This is a competent substitute for the imported senna as 
a cathartic, but must be administered in rather larger doses. 
It is much used in the form of infusion, combined with fen- 
nel, or some other aromatic, to prevent griping.] 



CASTOREUM—CASTOR. 

\A jieculiar concrete substance obtained from Castor Fiber, U. S. 

Officinal Preparation, U. S. 

Tinctura Castorei. Dose, f'5ss-ij (2. to 8. Gm.).] 

Castoreum and musk possess much the same properties, 
the only difference being in the greater strength of the 
latter. They are stimulant and antispasmodic ; but cas- 
toreum is rarely if ever used, and even musk, which was 
formerly much valued in France, and by Graves of Dublin, 
in typhus, pneumonia, and other diseases tending to assume 
an adynamic type, has now also fallen into comparative 
disuse. 

18 



206 CATNEP — CATECHU. 

[CATARIA—CATNEP. 

The leaves and tops of Nepeta Cataria, U. S. 

Infusion of catnep (catnep tea) is a favorite remedy for 
flatulent colic in infants, but is rarely used for any other 
purpose in regular practice, although a hot infusion is a 
domestic remedy for amenorrhcea and hysteria.~\ 



CATECHU— CATECHU. 

[An extract prepared principally from the wood of Acacia Catechu, U. S. 

Officinal Preparations, U. S. 

Infusum Catechu Compositum. Dose, f^j-iij 
(32. to 96. Griri.). 

Tinctura Catechu. Dose, f'3j-"j (4. to 12. Gm.).] 

Internal Effects. 

Pltysiological. Therapeutical. 

Catechu lias powerful as- It is a much-used drug in 
tringent properties. the relaxed conditions of 

various mucous membranes, 
but more especially in diar- 
rhoea, and it constitutes an 
essential ingredient in the 
mixtures generally prescribed 
for the relief of that condi- 
tion. 

P>. Tincturse catechu 

Pulveris cretse aromatici [Br.] 

Tincturse opii 

Mucilaginis acacias 

Aqua? cinnamomi q. s. ad f^vj ; " 192 

Misce, fiat mistitra, cujus sumat seinunciam post singulas dejee- 
tiones liquidas. 



f5vj; 


or 


24 


Gm 


5i.i; 


" 


■ 8 


" 


t'3ij; 


<( 


8 


a 


fSj ; 


a. 


32 


n 



[Cerata. 

List of Cerates officinal in the U. S. Pharmacopoeia : — 

Ceratum (formerly Ceratum adi- Ceratum Resime. 

pis). " Resinse Compositum. 

Ceratum Cantharidis. " Sabinse. 

" Cetacei. " Saponis. 

" Extracti Cantharidis. " Zinci Carbonatis.] 

" Plumbi Subacetatis. 



WAX — SPERMACETI. 207 

CERA—WAX. 

fCera Alba. Yellow wax bleached, U. S. 
Cera Flava. A peculiar concrete substance prepared 
by Apis mellifica, U. S. 

Wax is a good excipient, and is the basis of the cerates. 
It also enters into pills, ointments, plasters, and suppositories. 
It was an ancient remedy for dysentery.'] 

C E RIUM—C E RIUM. 

[Cerii Oxalas — Oxalate of Cerium. Dose, gr. j-v 
(.00 to .30 Gm.).] 

The oxalate of cerium, in doses of from gr. j to gr. ij, is 
a popular remedy in the vomiting of pregnancy, its mode of 
action being quite unexplained, and its success being, accord- 
ing to my own experience, greatly exaggerated. 

It is generally prescribed in the form of pill. 

fy. Cerii oxalatis gr. xxiv ; or 150 Gm. 

Extraeti gentianse gr. xxxvj ; " 2,40 " 

Misce, fiaiit pilulfe duodecim, quarum capiat unam bis in 
die. 

[Disappointment from the, use of this drug may be ex- 
plained by the fact that the commercial oxalate of cerium 
often contains salts of lanthanum, didymium, and other im- 
purities. The chemically pure oxalate of cerium is probably 
one of the most efficient remedies against the vomiting of 
pregnancy that we possess; given in powder, in pill, or 
suspended in mucilage.] Another reason for disappointment 
probably is that the usually prescribed dose is much too 
small. Some good authorities advise us to give ten grains 
every four hours, one dose being invariably taken before the 
patient rises from bed. It has also recently been recom- 
mended in doses of from 5 to 10 grains as a very efficient 
remedy for cough [and in smaller doses to children for 
whooping cough.] 



CETACEUM— SPERMACETI. 

I A peculiar concrete substance obtained from Physeter macrocepkalus, 

U.S. 

Officinal Preparations, U. S. 

Cera turn Cetacei, Charta Cantharidis, Unguentum Aquae 
Rosaiv] 



208 ICELAND MOSS — PIPSISSEWA. 

Requires no special notice. [Its internal use lias been 
generally abandoned. The cerate, a perfectly bland prepa- 
ration, may be used as a dressing to blistered surfaces. The 
unguentum aqua? rosas, or cold cream as it is called, is much 
used for chapped hands and lips, and excoriated places.] 



CETRARIA— ICELAND MOSS. 

[Cetraria Islandica (Acliarius, Lichen Univ.), U. S. 

Officinal Preparations, U. S. 

Deeoctum Cetrariae. Dose, f^ss-ij (16. to G4. Gm.).] 

This plant is supposed to have nutritious pi-operties [and 
formerly enjoyed a great reputation as a demulcent and tonic 
in 'pulmonary ajf'ections~\. 



[Chartae. 

The officinal papers are Charta Cantharidis and Charts, 
Sinapis.] 



[CHENOPODIUM— WORMSEED. 

The fruit of Chenopodium Anthelminticum, U. S. 
Dose, in substance, gr. xx-xl (1.30 to 2. GO Gm.). 

Officinal Prefaration. 

Oleum Chenopodii. Dose for a child, gtt. v-x (.30 
to .00 Gm.). 

Internal Effects. 

A popular remedy against lumbricoid worms. It may be 
given night and morning for two or three days, then to be 
followed by a brisk cathartic] 



[CHIMAPHILA—PIPSISSEWA. 

The leaves of Chimaphila ^umbellata (Pursh, Flor. Amer. Sept.), U. S. 
Officinal Preparations, U. S. 

Deeoctum Chimaphilse. Dose, ad libitum. 
Extraetum Chimaphilee Fluidum. Dose, tt^xx- 
xi (1.30 to 2. GO Gm.). 



CHIRETTA — CHLORAL. 



209 



Wintergreen is an Indian remedy for scrofula, rheuma- 
tism, and nephritic affections, and it enjoys some reputation 
as an alterative in regular practice, and has been recom- 
mended as a diuretic in dropsy. It is also tonic and astrin- 
gent.] 



[CHIRETTA— CHIRETTA. 

The herb and root of Agathotes Chirayta, U. S. 
Not much used in this country. See note under Gentian.] 



CHLORAL—CHLORAL. 

[Syn. Hydrate of Chloral, U. S. 
Treatment of Poisoning. 

Strychnia is the physiological antidote for chloral ; and 
the treatment must be conducted on general principles for 
narcotic poisoning, by evacuants, counter-irritants, stimu- 
lants, and maintaining bodily heat.] 

Local Actions. 
Physiological. Therapeutical. 



When applied externally, 
chloral has been by some 
authorities supposed to have 
sedative properties, although 
the soothing action is pre- 
ceded by some smarting and 
irritation ; it is also an un- 
doubted antiseptic. 



It -has been recommended 
as an external application in 
neuralgia, rheumatism, and 
other painful affections. 

Used as a dressing to ulcer- 
ated surfaces, it seems to act 
well by removing the fetor 
of discharges and lessening 
pain ; and it has been success- 
fully employed, in solution, 
for the preservation of ana- 
tomical preparations, and for 
the injection of bodies, the 
only drawback to this being 
the disagreeable smell which 
results, and a certain amount 
of blackening of the tissues 
on exposure to the air. It is 
also used to check the irrita- 
tion of eczema and prurigo. 



18* 



210 



CHLORAL. 



I. Nervous System 1. 

Brain Chloral [acts as a 

sedative to the nervous cen- 
tres and secondarily to the 
heart. In small do^es it pro- 
bably] produces an anaemic 
condition of the brain, and 
thus causes sleep by imitat- 
ing the natural anatomical 
arrangement of that process. 
The resulting slumber begins 
xary quickly after the dose 
is swallowed, it is usually 
sound and dreamless, and 
the patient wakes in seven 
or eight hours, well re- 
freshed, and w i t h o u t any 
marked feelings of malaise 
or d i gesti ve d i s t u r bance. 
Exceptions to this, however, 
have been observed, and in 
these chloral has caused pre- 
liminary excitement; but it 
is more than probable that 
an explanation may be found 
in the use of the impure spe- 
cimens of the drug too often 
retailed. Liebreich believes 
that chloral exerts its hyp- 
notic influence by undergoing 
transformation in the blood 
into chloroformic and formic 
acid ; but this is improbable 
for the following reasons : — 

(1) The alkali of the blood 
is too feeble to liberate the 
chloroform, and the albumen 
is considered antagonistic to 
such a process. 

(2) No smell of chloroform 
can be observed in the breath 



Constitutional Actions. 

1. Chloral is an excellent 



hypnotic, causing sound and 
refreshing sleep, without the 
digestive disturbance which 
usually follows the use of 
opium. It may be given in 
simple insomnia from mental 
worry, overwork, or other 
causes, and it is a remedy of 
great value in all diseases in 
which dangerous depression 
is apt to follow the continu- 
ous want of sleep. Thus, in 
t/jjthus, in delirium tremens, 
where it must be pushed bold- 
ly in conjunction with an ab- 
solute suspension of all alco- 
hol, in phthisis, acute mania, 
etc., we may prescribe it with 
much confidence of success. 
It has also been recommended 
in France as an anesthetic 
by [intravenous] injection; 
from 2 to 4 grammes, thus 
made to enter the veins, be- 
ing there supposed to yield 
chloroform, which then ex- 
erts its usual influence. There 
is no reason, however, to be- 
lieve that anesthesia thus pro- 
duced would be in any degree 
safer than the old mode of in- 
halation ; and as the patient 
is thus exposed to the addi- 
tional risks of thrombosis, in- 
flammation of the veins, and 
the entrance of air, one can- 
not wonder that this process 
has found no favor in this 
country. In addition to this, 
recent observation goes to 



CHLORAL. 



211 



and no anaesthetic effect is 
produced on the sleeper by- 
moderate doses. 

2. Spinal Cord.— The re- 
flex irritability of the spinal 
cord is very decidedly less- 
ened, and the respiratory cen- 
tre becomes weakened, and 
eventually paralyzed. 



3. Sympathetic and General 
Nervous System — The vaso- 
motor system is enfeebled, 
but no special effect seems to 
be produced on other nervous 
structures, unless we believe 
a part of the loss of muscular 
power, sometimes observed in 
those who have taken chloral 
for some time, to be due to an 
action on the motor nerves. 

II. Circulatory System. — 
Chloral has a powerful action 
on the heart, lowering and 
weakening its action by para- 
lyzing its contained sympa- 
thetic ganglia. That this ef- 
© © 

feet is not produced through 
the medium of the vagi is 
shown by the fact that it 
comes on even after these 
nerves are cut, and the ter- 
minal cardiac filaments para- 



show that it is in no sense a 
true anaesthetic. 

2. Chloral is of service in 
some spasmodic diseases, as 
chorea, whooping -cough, asth- 
ma, incontinence of urine, 
labor, after-pains, etc. It is 
also undoubtedly useful in 
[trismus nascentium, pucr- 

peral convulsions, and] cases 
of tetanus, many of which 
have recovered during its ad- 
ministration ; Gubler record- 
ing 3G, with the proportion 
of 21 recoveries, whilst C bo- 
part has collected from all 
sources 80 successful cases. 
It may also be given as an 
antidote to strychnia. 

3. Chloral, having no in- 
fluence over sensory nerves, 
has no power, per se, of allay- 
ing pain, and is, therefore, 
useless in that class of cases 
where opium is of such signal 
service. It seems, however, 
to relieve the pain of labor, 
without causing inertia of 
uterus, or doing harm to mo- 
ther or child. 

II. Chloral, weakening 
cardiac action, must not be 
given where we have any rea- 
son to suspect an enfeebled 
state of the heart muscle. 
This shows how useless chlo- 
ral is likely to be as a narco- 
tic, when flaccid vessels allow 
free gravitation of blood to 
the brain during the recum- 
bent posture, thus congest- 
ing its tissues, and effectually 



212 



CHLORAL. 



lyzed by atropine. Along 
with this slowing of the pulse 
we get lessened arterial ten- 
sion from • dilatation of the 
superficial vessels. [Profes- 
sor Wood 1 considers it most 
probable that the chloral in- 
fluences the heart through the 
centres at the base of the 
brain.] 

III. Respiration and Tem- 
perature The breathing 

tends to become slower, and 
finally to cease, from paraly- 
sis of the respiratory centre ; 
but urgent dyspnoea has occa- 
sionally been observed, and 
this has been ascribed to dila- 
tation of the pulmonary ves- 
sels, causing an increased af- 
flux of blood to be directed 
suddenly to the lungs. 

The temperature falls, and 
this is no doubt due to sur- 
face evaporation produced by 
the dilated cutaneous vessels. 

IV.. Secreting and Diges- 
tive Systems. — No special in- 
fluence is produced on any of 
these, but occasionally vomit- 
ing and purging have followed 
the use of chloral. 



preventing sleep. Its action 
is most manifest when the 
circulation is strong and the 
arteries tight. 



III. This effect on the re- 
spiratory centre naturally sug- 
gests caution in prescribing 
chloral in cases of advanced 
bronchitis with rapidly accu- 
mulating mucus secretion and 
deficient oxygenation of the 
blood. It has been much 
used in whooping-cough, but 
I have been unable to trace 
any special therapeutic effect 
beyond the soothing of the 
cough at night by producing 
sleep. 

Chloral has been recom- 
mended as a good remedy in 
sea-sickness. 



Absorption and Mode of Elimination. 

Chloral is rapidly absorbed by the blood, and given out 
probably by the urine, the breath, and perhaps the skin. 

Poisonons Effects. Antidotes. 

Chloral may kill by car- Here our efforts must first 

diac syncope, and, as this ef- be directed to obviating the 



1 [Therapeutics and Materia Medica, 2d ed., Philada. 1877, p. 
321.] 



CHLORAL. 



213 



feet has been known to follow 
a single dose of 30 grains, 
considerable caution must be 
exercised in its use ; or again, 
death may ensue from paraly- 
sis of the respiratory centre, 
with coma and gradual suffo- 
cation ; and, finally, a series 
of cases has been recorded in 
which symptoms arose akin 
to blood poisoning, with pur- 
puric and scorbutic eruptions, 
ulceration of gums, and great 
prostration, ending in death. 



tendency to death. "We must 
endeavor to restore the heart's 
action by warmth, stimulants, 
strong coffee, and promote 
breathing by irritation of the 
surface, galvanism, and arti- 
ficial respiration ; counteract 
the rapidly-lowering tempe- 
rature, on which so much 
danger depends, by warmth ; 
and finally employ physiolo- 
gical antidotes, such as atro- 
pia and strychnia. One case 
is recorded in which alarming 
symptoms, caused by taking 
370 grains, were removed by 
two subcutaneous injections 
of strychnia. 



Cautions, Mode of Administration, Dose, etc. 

[It is recommended that re-crystallized chloral only should 
be prescribed, as the commercial article is liable to be con- 
taminated with impurities, and the results of decomposition. J 
Liebreich holds that many of the commonly described bad 
effects of chloral are due to impure preparations, which are 
unfortunately only too effectually masked by the syrups now 
in such general use. It is easy to detect impurity of the 
crystals, which should not be acicular in form, and cake 
chloral should always be distrusted. 

The use of chloral requires caution, as many instances of 
death from its employment are on record, and other cases 
have been noted in which very serious symptoms followed 
doses varying from 10 to 50 grains. We must also be mind- 
ful of other physiological peculiarities. Thus great muscular 
prostration, more especially affecting the legs, and causing 
staggering, not very unf'requently follows its continued use. 

Persons vary, however, in a very remarkable manner with 
regard to their susceptibility to the action of chloral, alcohol- 
ism lessening this in marked degree. Mr. Hulke (Clin. Soc. 
Trans. 1875) records a case in which a young lady, rct. 23, 
took in one dose 320 grains, causing lividity, failure of re- 
spiration, weakened action of the heart, and contraction of 



214 CHLORAL. 

the pupils, from which she was recovered with difficulty by 
the stomach-pump, artificial respiration, and strong coffee. 
Mr. Bishop, of Boston, had a case in which a patient, suf- 
fering from delirium tremens, took 165 grains, followed by 
thirty-six hours' profound sleep, and a perfect cure on waking. 

Prof. Gairdner met with a case of chorea in a little girl 
of eight, where 45 grains were taken by mistake with perilous 
immediate consequences, but entire removal of the disease. 
It is believed on somewhat vague evidence, that chloral-eating 
is practised on a large scale with resulting cerebral anaemia, 
and moral and muscular weakness ; and the best-marked case 
I have met with is published by Mr. Tuflis, of the Edinburgh 
Asylum (Edin. Med. Journ. 1877), where 180 grains were 
regularly taken every day in frequent doses, causing dys- 
pepsia, moral perversion, muscular weakness, a feeble heart, 
loss of memory, and epileptiform fits, speedily removed by 
withdrawal of the drug. 

Various skin eruptions, usually confined to the face, begin- 
ning as spots of roseola, coalescing to form patches of ery- 
thema, occasionally generally diffused purpuric patches, and 
the very peculiar deep flushing of the face following the use 
of stimulants, and due no doubt to vaso-motor paralysis, have 
been carefully described by Dr. Crichton Browne and other 
observers. 

There seems no doubt that chloral acts more powerfully in 
persons whose blood is strongly alkaline, and Prof. Konig 
found that the previous administration of sodium bicarbonate 
heightens the narcotic effect. In this way is explained the 
great susceptibility to the action of chloral noted by Dr. 
Russell, of Glasgow, in typhus fever. Liebreich believes it 
to act unfavorably in acute rheumatism, on account of the 
acid state of the blood. He recommends us never to give it 
on an empty stomach, nor to combine it with milk. 

Considering the undoubted fact that not only dangerous 
symptoms, but even death, have followed a dose of 30 grains 
[and even of 10 grains], we must begin, as a rule, with 20 
grains [or a smaller quantity], to be repeated as occasion 
requires. We must remember, however, that the narcotic 
action of chloral is not invariably exhausted in the single 
sleep to which it originally gives rise, but it may be held 
over until next night, so that our best practice will be to give 
a full dose only once in the forty-eight hours. The taste and 
smell of chloral being pungent and disagreeable, we must 



CROTON-CHLORAL. 215 

endeavor to render our prescription as palatable as we can. 
The syrup contains 10 grains to the drachm. Or we may 
use the following formula : — 

T£. Chloral, hydratis gr. xx ; or 1 30 Gm. 

Syrupi aurantii f.^j ; " 4 " 

Aq. menth. pip. q. s. ad f.^ij ; " 64, " M. 

Fiat haustus bora somni sumendus. 

[The addition of gr. v of chloral to a small dose of morphia 
greatly adds to its hypnotic effect, and prevents unpleasant 
results that sometimes are produced by morphia alone.] As 
a preservative fluid for anatomical purposes we may use gr. v 
ad *j ; as a dressing for wounds, ulcers, and sore nipples, etc., 
gr. xv ad ^j ; in eczema, gr. xxx to lx to an ounce of lard. 

[Note. — Chloral-Camphor. By rubbing together gum camphor 
and chloral, a fluid is produced resembling simple syrup. This has 
been recommended as a local anaesthetic in neuralgia, applied with 
a brush to the external skin. It is rubefacient, but not vesicating.] 
By the addition of this to unguentnm an application may be con- 
veniently and very efficiently made to prurigo (Bulkeleyj. 



Croton-Chloral— Butyl Chloral Hydrate. 

(Not Officinal.) 

[A hydrate of tricMorbutylaldehyd made by the action of chlorine upon 
acetic aldehyde and distillation.] 

The name of Butyl Chloral, advised by Liebreich, would 
be an improvement, as preventing the idea of any relation- 
ship to croton oil. Dose, gr. iij to x (.20 to .60 Gm.). 

Local Action. 
Xone has been described. 

Constitutional Action. 

Physiological. Therapeutical. 

I. Nervous System 1. 1. Croton-chloral has been 

Brain. — Croton - chloral highly praised by its disco- 
causes sleep in from fifteen to verer, Liebreich, as a nar- 
twenty minutes. cotic, being given by him in 

doses of from 15 to 30 grains 
(1. to 2. Gm.). There is 
little English experience to 



216 



CROTON-CHLORAL, 



2. Spinal Cord No ac- 
tion is produced on the spinal 
cord, nor consequent muscu- 
lar relaxation. Some para- 
lyzing influence is eventually 
excited on the medulla. 

3. Sympathetic and other 
Nervous Systems No influ- 
ence seems to be exerted on 
the vaso-motor .nerves, but on 
the fifth a well-marked seda- 
tive effect is noted, indicated 
by anaesthesia of the head and 
face, loss of irritability of the 
eyeball, and failure of the 
nerve-trunk itself to respond 
to galvanic stimulation. 



quote on this heading, as the 
doses used here are far too 
small to produce sleep-; but 
as the drug has no depressing 
action on the heart like chlo- 
ral, there is no doubt that we 
may prescribe it with com- 
parative freedom. [Subse- 
quent experience has shown 
that in some patients danger- 
ous and even fatal symptoms 
have been produced by ordi- 
nary doses in cases of organic 
heart disease. It appears to 
resemble chloroform in its un- 
certainty and danger.] 



II. Circulation. — Croton- 
chloral has no tendency to 



3. The anaesthetic influ- 
ence of croton-chloral would 
naturally suggest its use in 
facial neuralgia, and a good 
deal of success has been thus 
obtained in dealing with this 
troublesome affection, doses 
of from 2 to 6 grains having 
generally been prescribed. 
Liebreich has so much faith 
in this sedative action, as to 
advise its use as an anaesthetic 
in operations about the face. 
[Before administering this 
remedy the heart should al- 
ways be examined, as croton- 
chloral is contra-indicated by 
cardiac disorder.] 



CHLORINE. 



217 



weaken or lower the action 
of the heart in health. 

III.* Respiration and Tem- 
perature. — Croton - chloral 
tends to lower the rate of 
breathing, and eventually 
kills by paralyzing the respi- 
ratory centre. (It is better 
to dissolve croton-chloral in 
glycerine and water, than in 
alcohol.) 



[III. Croton-chloral close- 
.ly resembles chloral hydrate 
in its action upon the system, 
except in possessing greater 
danger. For this cause its 
use has been almost entirely 
discontinued in this country.] 



CHLORINUM—CHLORINE. 

[ Aqua Chlorini, U. S. Chlorine-water. Dose, largely 
diluted, f'5j-iv (4. to 1G. Gm.).] 

The use of chlorine is almost entirely confined to its ex- 
ternal application. 



Physiological Action. 

1. Concentrated chlorine 
gas directed upon the skin 
causes redness and smarting, 
followed by a pustular erup- 
tion and -even erysipelatous 
inflammation. 

2. It is an excellent disin- 
fectant, decomposing sulphu- 
retted hydrogen and ammo- 
nium sulphide at once and 
more effectually than any 
other gas, and also destroys 
organic matter in the air, as 
it bleaches organic pigments 
and destroys odors, either by 
abstracting hydrogen or by 
oxidizing (Parkes). 

3. The inhalation of chlo- 
rine gas is stimulating or irri- 
tating to the lungs. 



19 



Therapeutical Action. 
1. It is never, however, 
used as a counter-irritant. 



2. It is therefore exten- 
sively used as given off by 
chloride of lime to purify the 
air from offensive effluvia, 
and to destroy infectious 
germs. In the form of lotion 
it is also used to cleanse foul 
or slouching; sores. 



3. It has therefore been 
used in some forms of chronic 
bronchitis and phthisis, but 
is not now much employed. 
[It may be used in strychnia- 
2wisoning.~\ 



218 CHLOROFORM. 

Internal Use. 

Chlorine used to be given internally in medicine in various 
infectious fevers with a view to disinfection, but this has now 
become quite obsolete. [As extemporaneously made by the 
action of muriatic acid 5j> upon chlorate of potassium gr. x, 
to which a pint of water is added in successive portions, it 
is recommended by Watson for diphtheria and other zymotic 
diseases.] 

Dose and Mode of Administration. 

As a disinfectant it maybe obtained by acting on chloride 
of lime with water or dilute sulphuric acid, or by -pouring 
four parts by weight of strong hydrochloric acid on one part 
of powdered binoxide of manganese, or mixing four parts of 
common salt and one of binoxide of manganese with two 
parts by weight of sulphuric acid and two of water, varying 
the quantities according to the size of the room. 

Vapor chlori [Br.] is used for inhalation, and liquor chlori 
[Br.] may be employed diluted as a lotion, or given inter- 
nally. 

Disadvantage. 

The great drawback of chlorine is the very irritating 
nature of its vapor, rendering it unsuitable for general use in 
rooms actually inhabited by the sick. 



CHLOROFORMUM— CHLOROFORM. 

[Chloroformum Venale, U.S. Commercial Chlo- 
roform. 

Chloroformum Purifieatum, U. S. Purified Chlo- 
roform. Dose, nrx-xxx (.tio to 1.30 Gm.) largely diluted. 

Officinal Preparations, U. S. 

Mistura Chloroformi (chloroform gss troy, camphor 
gr. lx, yelk of one egg, and water f^vj). Dose, f^ss (16. 
Gm.). 

Spiritus Chloroformi (a troy ounce to alcohol f|xij, 
U. S.). 1 Dose, f5ss-j (2. to 4. Gm.). 

Liniment um Chloroformi (f chloroform, | olive 
oil). 

1 [Spiritus Chloroformi, Br,, contains one part in twenty.] 



CHLOROFORM. 



210 



It is used in the manufacture of Liquor Gutta-Perchae, and 
in preparing Atropia. 

Poisoning. 

In the treatment of chloroform-narcosis, when there is 
failure of the circulation, vigorous and prompt measures are 
called for. The surface of the chest should be smartly slapped 
with the fringe of a towel dipped in ice-water, a piece of ice 
may be introduced into the rectum, the head must be lowered 
and the legs elevated, and ammonia held to the nose ; an 
assistant meanwhile practising artificial respiration. This 
treatment Prof. Gross has found to be invariably effective, 
and he has not lost a patient out of more than 5000 cases of 
chloroform-anaesthesia.] 

Local Action. 



Physiological. 

Chloroform when allowed 
to remain for some time in 
contact with the skin, acts as 
an irritant, causing redness 
and smarting, followed by 
vesication. 

It has also, however, some 
sedative properties. 

Choloroform is an excellent 
solvent of caoutchouc, gutta- 
percha, and many fats and 
resins, and it also greatly as- 
sists the cutaneous absorption 
of most of the alkaloids. 



Therapeutical. 

The locally sedative action 
of chloroform has led to its 
extensive use as an applica- 
tion for the relief of rheu- 
matic or neuralgic pains, the 
liniment being a convenient 
form. 

It is also a useful remedy 
for allaying the itching of 
some chronic forms of shin 
disease. 



Constitutional Action. 



Chloroform, when taken 
internally, may act as a stim- 
ulant, sedative, and anti- 
spasmodic. There seems, 
occasionally, little doubt that 
[when administered for its 
anaesthetic effects, under cer- 
tain circumstances,] it excites 
erotic sensations in women, 



It is a useful remedy in 
hysteria, asthma, andnervous 
palpitation, for the arrest of 
sea-sickness and other forms 
of vomiting, and for the 
soothing and quieting of some 
forms of irritable cough. 



220 



CHLOROFORM. 



and leads them to bring un- 
founded accusations against 
medical men. 



Combined Local and Constitutional Effect. 

Under this heading it may be convenient to discuss the 
anaesthetic properties of chloroform, and this we will now 
proceed to do on the plan adopted generally throughout these 
pages. 



Physiological. 

1. On Brain and Nervous 
System. — Chloroform has 
first a stimulating, and sec- 
ondly a sedative, action on 
the brain, a good deal of 
excitement and struggling 
taking place during the early 
stages of inhalation, whilst, 
during the later, narcosis is 
complete, and the patient 
lies quiet and motionless. 
This condition resembles 
natural sleep in being asso- 
ciated with anaemia of the 
brain, but differs by its ren- 
dering the patient quite in- 
sensible to external impres- 
sions, including the most 
severe cutting operations, 
this effect being due to a 
paralyzing influence of the 
drug on the ganglionic cen- 

© © © 

tres of the sensory nerves. 

The reflex functions of the 
cord are also lulled to slum- 
ber, and, if the inhalation is 
pushed too far, paralysis of 
the respiratory centre may 
ensue. 

2. Heart and Circulation. 
. — On the heart the influence 



Therapeutical. 

1. In the early stage of 
inhalation the patient usually 
feels confused and giddy, 
his eyes are suffused, his face 
congested, and the heart 
beats rapidly. This is often 
followed by apparent insen- 
sibility, from which, how- 
ever, he can readily be 
roused, and very frequently 
a stage of violent excitement 
ensues, during which he 
struggles violently and with 
remarkable muscular force, 

talking and singing incohe- 

© © © 

rently meanwhile. This 
stage has been compared with 
that of alcoholic intoxica- 
tion. Succeeding to this we 
have that of " anaesthesia," 
in which he is profoundly 
insensible, with contracted 
pupils ; and finally we reach 
that of " narcosis," in which 
the face becomes congested, 
the pupils dilate, and sterto- 
rous breathing sets in. Chlo- 
roform inhalation is only 
used during its first stage to 
alleviate the pain of child- 
birth, it being found that 



CHLOROFORM. 



221 



of chloroform is at first 
slightly stimulating, the pulse 
becoming quickened ; but 
secondary depression follows 
from a paralyzing influence 
on the sympathetic ganglia, 
the pulse now growing 
slower, and the arterial ten- 
sion becoming lowered. 

3. Respiration and Tem- 
perature. — The respiration 
tends at first towards in- 
creased rapidity, but if the 
inhalation is pushed so far 
as to affect the respiratory 
centre, the breathing grows 
slower and finally ceases. 
[It may cease suddenly with- 
out warning ; and there is no 
means of determining pre- 
viously, at least with our pre- 
sent knowledge, when this 
accident will occur, or what 
patients are particularly liable 
to it. This is the great ob- 
jection to chloroform.] We 
usually observe some tend- 
ency to perspiration attend- 
ing chloroform inhalation, 
and a consequent slight re- 
duction of temperature. 

4. On the digestive and 
secreting organs chloroform 
seems to exert no marked 
influence, the sickness so fre- 
quently observed during re- 
covery being purely reflex in 
character. 

Poisonous Properties. 

Chloroform may kill in During chloroform -in hala- 

two ways. (1) By primarily tion we must watch the pulse, 
paralyzing the heart, and this and specially note enfeeble- 

19* 



full anaesthesia under these 
circumstances is apt to relax 
the uterine muscular tissues, 
and not only to check their 
contraction, but to predis- 
pose to future hemorrhage. 

During the second stage 
chloroform is used for the 
purpose of obtaining full and 
complete insensibility to pain 
during the performance of 
operations ; and this invalu- 
able property has deprived 
the practice of surgery of 
much of its former horrors. 

We also employ it freely 
to relax muscular tension 
and spasm, and so facilitate 
the reduction of hernia aud 
dislocation ; for diagnostic 
purposes, in order to dispel 
phantom uterine tumors, as 
well as to enable us to make 
a careful examination of ex- 
tremely painful parts. 

It is also of service for 
the relief of various forms 
of spasmodic affections, as 
ivhooping - cough, infantile 
and puerperal convulsions, 
chorea, and to alleviate pain, 
in cancer, during the passage 
of renal or biliary calculi, 
and under many other condi- 
tions. 



222 



CHLOROFORM. 



has generally been considered 
to be due to the inhalation 
of air too highly charged with 
chloroform vapor, Mr. Clo- 
ver holding that over 5 per 
cent, must be considered 
dangerous. Dr. Brunton, 
however, explains very inge- 
niously how it is that small 
doses are more apt to produce 
this effect than large, exciting 
as they do that irritative ac- 
tion of the terminal filaments 
of the 5th nerve, which are 
well known to cause stoppage 
of heart; and thus shows us, 
what could hardly be under- 
stood before, why so consi- 
derable a proportion of chlo- 
roform deaths have occurred 
during the performance of 
very trivial operations, or 
where the vapor has been 
timidly given. 1 

It seems highly probable, 
however, that, in accordance 
with the views of Syme, Lis- 
ter, Chiene, etc., fatal acci- 
dents from chloroform are 
not so liable to proceed from 
the heart as (2) from the 
respiratory function ; and this 
mode of fatal accident has 
been again subdivided into 
two headings: 1st. Death by 
apncca, or stoppage of the 
breathing from nervous in- 
fluence or mechanical causes ; 
and this may arise, either 
from the tongue falling back, 



ment, irregularity, or cessa- 
tion of its beats. Sudden 
pallor of the face, lividity 
and gasping for breath are 
signs of ill omen. If the ac- 
tion of the heart seems to 
fail, we must administer 
stimulants by the mouth or 
rectum, and excite the cuta- 
neous surface. Galvanism 
seems more likely to exhaust 
than excite the contractility 
of the heart muscle ; and 
galvano-puncture, so much 
vaunted by foreign observers, 
has not been tried in this 
country. 



Chloroform accidents de- 
pending, in a great majority 
of cases, on failure of respi- 
ration, we must endeavor to 
re-excite this function by 
cold sprinkling, or ammonia 
vapor, but, most hopefully, by 
the steady and persevering 
use of artificial respiration. 
Always, however, see that 
no mechanical hindrance to 
breathing exists, and more 
especially take care to draw 
the tongue well forward ; 
this little operation acting 
not only by removing its own 



1 [If this were true, there should be more deaths from heart-fail- 
ure under ether than chloroform, because ether is more irritating 
to the upper air passages than chloroform.] 



CHLOROFORM. 



223 



or, 2dly, from closure of the 
glottis by paralysis of the in- 
trinsic muscles of the larynx. 
Of these, the first is by far the 
more common, and death is 
often caused by falling back of 
the tongue, closing the glot- 
tis. It therefore follows that, 
whilst engaged in the admin- 
istration of chloroform, the 
breathing must be very care- 
fully watched. 3. Death may 
also be produced by asphyxia, 
or suffocation from excessive 
formation of carbonic acid in 
the blood. [The density of 
chloroform vapor being much 
greater than atmospheric air, 
if given freely and without 
proper dilution, it may cause 
suffocation directly, by filling 
the air-cells and excluding 
oxygen, owing to the diffi- 
culty of diffusion of such a 
heavy vapor. This may ex- 
plain the utility of Nelaton's 
method, which has been fol- 
lowed by such successful re- 
sults in threatened death from 
chloroform. (See paper on the 
Physics of Anaesthetics, by 
Dr. Win. H. Greene, in the 
Am. Journ. of Med. Sci. for 
April, 1882.)] 

Absorption and Elimination. 

Chloroform is rapidly absorbed and rapidly given off by 
the breath and urine, in which secretion it can be readily 
detected. 

Mode of Administration. 

Fatal accidents from chloroform have become so alarm- 
ingly frequent of late — the total number, according to Bartho- 



mechanical impediment to 
breathing, but by drawing 
forward the epiglottis, pulls 
on the aryteno-epiglottidean 
muscles and opens the glottis. 
Mr. House, of Guy's Hospi- 
tal, has saved two cases of 
impending suffocation by tra- 
cheotomy. 

[It often answers the same 
purpose to raise the chin as 
far as possible from the 
sternum. 

Dr. Howard has recently, 
with good reason, advocated 
throwing the head backwards 
and downwards over the edge 
of a bed or couch, so that 
any fluid that might have en- 
tered the trachea would flow 
outwards. C] 

Galvanic stimulation of the 
phrenic nerve has been re- 
commended, and several ap- 
parently hopeless cases have 
been saved by the process of 
inversion as originally pro- 
posed by Nelaton. Nitrite of 
amyl has also been success- 
fully used by inhalation. 



224 CHLOROFORM. 



its use unjustifiable ; but it is on the whole by far the best 
anaesthetic, and, by adopting the following precautions, we 
may hope to imitate the success of the Edinburgh School, 
where danger or inconvenience rarely occurs, Mr. Syme hav- 
ing met with no death during 8000 administrations. Prof. 
Fraser, of Edinburgh, advises the subcutaneous injection, 
fifteen or twenty minutes before chloroform is begun, of T J^ 
to gL gr. of atropia combined with gr. J^ to gr. i of hydro- 
chlorate of morphia, with the object of stimulating the heart, 
obviating nervousness, and lessening or altogether preventing 
subsequent sickness. 

1. Never permit inhalation to take place in a sitting pos- 
ture, and see that the patient's neck is free from all con- 
striction. 

2. Give strict orders that no solid meal be taken for at 
least two or three hours previously [solid food should not be 
eaten for at least twelve hours, as a safe precaution], but a 
little beef-tea may be allowed, and a small sip of brandy is 
useful just before the operation. The sickness which so fre- 
quently attends a loaded stomach is not only inconvenient, 
but has proved fatal by suffocation from the drawing of 
vomited matters into the air-passages. And, in addition to 
this danger, vomiting is attended with special risks after 
such operations as ovariotomy and cataract extraction, and 
after the first of these it occasionally continues with exhaust- 
ing pertinacity. 

3. Use no special form of inhaler, but pour the chloro- 
form upon a towel or other porous material, and give it with 
care, allowing free admixture of the vapor with sufficient 
atmospheric air. Tell the patient to close his eyes and to 
inspire deeply, and when the period of excitement comes on 
do not suspend the inhalation, but keep the towel firmly ap- 
plied to the face until calm sleep is produced, or the slightest 
indication of stertor is heard. Complete anaesthesia is 
proved by the abolition of reflex action, as shown by insen- 
sibility of the eye when the cornea is lightly touched with the 
finger, by muscular relaxation, and by insensibility to pain. 

[4. If the action of the heart seems to fail, remove the 
chloroform and administer ether vapor for a few respirations. 
Do not give anything by the mouth. If the respiration be 
languid and intermit, assist the movements by gentle press- 
ure on the chest and abdomen. If the natural respiration 



CHLOROFORM. 225 

has ceased and the pulse is not distinctly felt, at once resort, 
to the more effective artificial respiration of Marshall Hall 
or Howard. Warmth should also be applied by the readiest 
means; galvanism, etc. C] 

When the operation is over, let the patient recover natu- 
rally, and do not disturb his sleep by the purposeless towel 
flickings so frequently to be seen in operating theatres. But 
the patient should be carefully watched for at least an hour 
after administration. 

As regards the quantity of chloroform to be used for each 
inhalation, it is impossible to lay down any rule, for the in- 
conveniences occasionally met with seem to bear no sort of 
proportion to the dose of the anaesthetic. [A couple of 
drachms may be poured from a dropping bottle upon the 
towel, and a few drops added from time to time to replace 
loss by evaporation. The chloroform should never be trusted 
to any but a skilled assistant.] If the chloroform be of good 
quality, it is safer, as shown by Brunton, to give it freely, 1 
and it is better to trust to our own care and skill than to the 
fancied safety of inhalers. It can never be possible to de- 
prive an unnatural condition like profound anaesthesia of all 
dangers, and even the theoretically safe instrument of Clover, 
with its guaranteed 3 per cent, of chloroform vapor, has been 
shown to be not absolutely free from risks. 2 

It would be very satisfactory could we lay down any laws 
for our guidance in anticipating danger from chloroform in- 
halation in any special class of cases, but this unfortunately 
we cannot do. It is now well known that neither organic 
disease of the heart nor conditions of extreme debility are 
contra-indications ; and although fatty heart is frequently 
discovered post-mortem, we cannot absolutely state that this 
is not a mere coincidence, nor can we pretend to diagnose 
such degeneration with any certainty during life. Some 
authorities believe that chloroform is more dangerous to the 

\} Surely Brunton's views hardly warrant so much, indifference 
to the dose of chloroform. The tendency to syncope is found to he 
in proportion to the strength of the vapor, whenever, by opening 
the windpipe, we make sure of its entrance into the kings. Ten 
per cent, of chloroform vapor, given in this way, is rapidly fatal 
by arresting the heart" s movement. The reason why chloroform 
has often been fatal in minor operations is, that it so often happens 
an extra dose is given that it may last long enough without further 
attention from the surgeon. C] 

2 [I am not acquainted with any case in which so little as 3 per 
cent, has been fatal to the human subject. C ] 



226 irisii moss — cinchona. 

old than the middle-aged or young, and there seems no doubt 
that habitual topers are brought under its influence with con- 
siderable difficulty. 

Chloroform is most generally given internally under the 
form of the spiritus chloroformi, or chloric ether, or as mis- 
tura chloroformi. [For the remarks of Mr. Clover upon the 
choice of anaesthetics, see page 58.] 



[CHONDRUS— IRISH MOSS. 

Chondrus crispus, U. S. 

Carrageen is demulcent and nutritive, and is used in de- 
coction (§ss to Oiij) flavored with lemon, as a tisane or 
drink for the sick. Boiled with milk it makes carrageen 
blanc mange, an acceptable and nourishing article of diet for 
an invalid.] 



CIMICIFUGA— BLACK SNAKEROOT. 

[ The root of Cimicifuga racemosa, U. S. 

Officinal Preparation, U. S. 

Extraetum Cimicifuga? Fluidum. Dose, fjss-j 
(2. to 4. Gm.). 

The decoction, although not officinal, has been used to a 
considerable extent, and with benefit, in the treatment of 
chorea in children. It is sedative and antispasmodic, and in 
large doses vomits.] 

This drug was introduced into practice in this country 
[England] some years ago by Sir J. Simpson, who praised 
it highly in chronic rheumatism, lumbago, and hypochon- 
driacal depression. It has been found useful in America as 
an emmenagogue, but has never taken any real hold upon 
professional attention at home. 

Dose of the tincture [Br.], 10 to 30 minims. 



CINCHONA— CINCHONA. 

[Syn. Peruvian Bark; Cinchona Baric. The bark of all species of the 
genus Cinchona, containing at least tivo per cent, of the proper cinchona 
alkaloids, which yield crystalline salts, U. S. 

Varieties. 

Cinchona Flava. The bark of Cinchona calisaya, 
U. S. 



CINCHONA. 227 

Cinchona Pallida. The bark of Cinchona Condami- 
nea, and of Cinchona micrantha, U. S. 

Cinchona Rubra. The bark of Cinchona succirubra, 
U.S. 

Officinal Preparations, U. S. 
Of the Yellow Bark :— 

Cinchoniae Sulphas. Dose, gr. ij-xxx (.12 to 2. Gra.). 

Decoetum Cinchonas Flavae. Dose, f's ij-iv (64. 
to 128. Gm.). 

Extractum Cinehonae. Dose, gr. v-xv (.30 to 1. 
Gm.). 

Extractum Cinchona? Fluidum. Dose, gtt. v-xv 
(.30 to 1. Gm.). 

Infusum Cinehonae Flavae. Dose, f^ij (64. Gm.). 

Quiniae Sulphas. Dose, gr. ij-xx (.12 to 1.30 Gm.). 

Pilulae Quiniae Sulphatis (each gr. j). 

Tinctura Cinehonae. Dose, f'5j-ij (4. to 8. Gm.). 

Of the Red Bark :— 

Decoetum Cinehonae Rubrae. Dose, f^ ij-iv (64. 
to 128. Gm.). 

Infusum Cinehonae Rubrae. Dose, f^ij (64. Gm.). 

Tinctura Cinehonae Composita (Huxham's tinc- 
ture). Dose, f'5j-ij (4. to 8. Gm.).] 

Effects and Uses. 

In any comparative estimate of the absolute importance 
of various drugs to the human species, cinchona would 
probably take the second place, the first being, by universal 
consent, accorded to opium. The bark itself, however, is 
not now of so much importance as in former years, when it 
was our sole dependable remedy for the poison of ague, and 
was then given in such enormous quantities as to be very 
embarrassing to the weak stomachs of feverish patients. 
This difficulty is now happily removed, and much greater 
precision and efficiency given to our treatment, by the intro- 
duction of quinine, the discovery of which in 1820 inaugu- 
rated a true era in therapeutics. 

The preparations of cinchona are now r used almost exclu- 
sively on account of their tonic properties, and in many cases 
of general debility, want of appetite, and loss of tone, most 



228 



CINCHONA. 



gratifying results are obtained by their employment either 
singly or in combination. Quinine itself, however, has a 
higher and wider therapeutic range, and has in recent years 
obtained so much of the careful attention of physiologists 
that we are bound to consider its properties with as much 
care and precision as the present state of science allows. 

Local Action. 

Quinine is occasionally, although rarely, used as a local 
application ; but the theory of this is so intimately bound up 
with its internal use, that we need not refer specially to it at 
present, save to note that an injection of gr. ij ad ^j lias 
been found of great service in checking the unhealthy secre- 
tion of an irritable bladder. 

Internal Action. 






Physiological. 

1. Nervous System. — 1. 

Brain Quinine in large 

doses causes curious brain 
symptoms, such as partial 
blindness, well-marked deaf- 
ness and ringing in the ears, 
giddiness, and frontal head- 
ache, associated with a pecu- 
liarly dull, heavy expression 
of countenance. Binz has 
suggested that some at least 
of these phenomena may be 
due to partial anaemia of the 
brain, caused by enfeebled 
action of the heart. Ham- 
mond, on the contrary, as- 
serts that quinine causes con- 
gestion of the brain. Gubler 
asserts that it stimulates the 
great sympathetic and audi- 
tory nerves. 

It contracts the uterus. 

2. Spinal System In 

frogs, quinine acts powerfully 



Therapeutical. 

I. The subcutaneous injec- 
tion of quinine has been 
highly recommended by Sur- 
geon - Major Hall in sun- 
stroke. 

This mode of administer- 
ing the dru£, however, is not 
unfrequently followed by in- 
flammation and even abscess 
at the seat of puncture. 
Gubler prefers the brom- 
hydrate to the sulphate, as 
being less irritating and bet- 
ter adapted for use in this 
way. 1 

The oxytocic action of qui- 
nine must be, in part at least, 
due to its action on the ner- 
vous system ; but its un- 
doubted power in contracting 
the uterus has not yet been 
much used in medicine. [It 
appears to be appreciated in 
the United States. Here it 



1 A hypodermic injection of sulphate of quinia has caused teta- 
nus. See National Dispensatory, Phila. 1879, p. 1179. 



CINCHONA. 



229 



iii reducing the reflex irrita- 
bility of the cord, the animal 
lying motionless, quite insen- 
sible to external impressions, 
the stillness being only- 
broken by occasional tetanic 
spasms ; but this action is 
contradicted by the more re- 
cent experiments of Binz. 

II. On Vascular System. 
— Moderate doses of quinine 
increase the frequency of the 
pulse, but, if larger quantities 
be given, the rate of pulsa- 
tion falls, the arterial tension 
diminishes, and death may 
even ensue from convulsions 
or sudden collapse following 
depression of the heart's ac- 
tion. 

Quinine has a direct action 
on the white corpuscles of the 
blood, checking their amoe- 
boid movements, and arrest- 
ing their tendency to migrate 
through the walls of the ca- 
pillaries under inflammatory 
conditions. 

It also prevents, in some 
degree, the due giving up of 
oxygen by the red corpuscles, 
and may thus interfere with 
the oxygenation of the tissues. 

III. Respiration and Tem- 
perature. — No influence on 
the respiratory function has 
been observed. On the tem- 
perature of a person in full 
health but little lowering 
effect is produced ; when tever 
is present, however, the tem- 
perature may be brought 
down by giving large doses. 

20 



is frequently used as a par- 
turifacient in single doses of 
gr. x— xv.] It has, however, 
been asserted that it may be 
injurious to the foetus. 



II. Quinine has therefore 
some stimulating properties. 
It has been shown to be a 
valuable remedy in 8 to 15 
grain doses, in combination 
with potassium iodide in cases 
of specific and non-specific 
serpiginous and phagedenic 
ulceration, after the failure of 
other remedies. 

An essential part of in- 
flammation and suppuration 
is now known to be extrusion 
of the white blood corpuscles 
from the capillaries, and their 
subsequent transformation in- 
to pus-cells. Quinine may 
therefore be of great service 
in localized inflammations, 
and in checking exhausting 
discharges from abscesses or 
wounds, and in pyaemia good 
results have followed its use. 

III. The antipyretic pro- 
perties of quinine are much 
prized in Germany, and it is 
there largely used in the 
treatment of typhus, typhoid, 
acute rheumatism, and pneu- 
monia. 

Immense doses, even reach- 
ing 75 grains, have been 
given, and it is observed that 



230 



CINCHONA. 



Opinions differ so much as 
to the explanation of this 
effect, that it is impossible to 
speak with any confidence on 
the question. [According to 
Henbach the cause of death 
in animals poisoned with 
quinia is a paralytic arrest of 
respiration.] 



IV. On Secretion In 

moderate doses, quinine in- 
creases the secretion of sa- 
liva, and augments, like most 
bitters, the flow of gastric 
juice, stimulating the appe- 
tite at the same time. 

If larger quantities, how- 
ever, are taken, an exactly 
opposite effect is produced ; 



tolerance of the drug is un- 
doubtedly present in fever, 
and that very much larger 
quantities can be taken than 
in a state of health. It is 
only when very freely given, 
however, that it has any cool- 
ing influence ; and we are 
advised to prescribe from 25 
to 45 grains in divided doses 
within the first half hour, and 
then allow an intermission of 
from 24 to 48 hours, as the 
effect would be diminished 
by spreading it over a longer 
time, on account of its rapid 
elimination. 

In this country we do not 
make very extensive use of 
quinine in febrile disorders, 
for the resulting diminution 
of temperature is only tem- 
porary, and has no influence 
on the progress of the dis- 
ease. When a really dan- 
gerous degree of pyrexia is 
reached, we know that we 
can hold it readily in check 
by cold baths. [But where 
hydropathic treatment is in- 
admissible, quinia in full 
doses is an efficient anti- 
pyretic] 

IV. Quinine is the best 
tonic we possess, increasing 
the appetite, and bracing up 
the intestinal mucous mem- 
brane. It is given, therefore, 
in all states of the system 
where debility is present, in 
simple loss of appetite, in 
some forms of dyspepsia, in 
neuralgia, especially of the 



CINCHONA. 



231 



hunger is blunted, and the 
alkaloid, acting as an irritant 
to the mucous membrane of 
the stomach, checks the gas- 
tric juice. The urine is found 
to be unaltered in quantity, 
but the amount of uric acid 
and probably of urea given 
off is decidedly diminished. 

V. Quinine is an excellent 
antiseptic, preventing and ar- 
resting decomposition. This 
it does in virtue of its poison- 
ous influence over minute or- 
ganisms, for we know that the 
process of decay is caused by 
the formation and rapid mul- 
tiplication, within the putre- 
fying fluid, of microscopic 
bodies called microzymes. 
Quinine in small doses para- 
lyzes, and in larger, destroys, 
these creatures, and so at 
once arrests further destruc- 
tive action. 

Some authorities have been 
inclined to explain its remark- 
able influence over ague by 
theoretically supposing that 
the essence of the malarial 
poison really consists in a 
minute germ or vegetable cell 
derived from the marshy land 
where the pestilence breeds, 
and that the antiseptic prop- 
erty of the drug is here the 
true explanation of its thera- 
peutic success. 

This seems to be borne out 
by the recent observations of 
Lanzi and Zerner, who have 
found an identical fungus in 
the decaying vegetation of 



supra-orbital nerve, in conva- 
lescence from acute disease, 
to arrest the nocturnal sweat- 
ing of phthisis, etc. 



V. In virtue of this poison- 
ous influence over protoplasm 
and minute germs, it has been 
recommended in large doses 
in whooping-cough, on the 
ground of destroying the vi- 
tality of the thick and tena- 
cious mucus which causes so 
much irritation in the bron- 
chial tubes, or, as others hold, 
by destroying the minute fun- 
gus on which the disease de- 
pends. [Henke.] Again, in 
hay-fever, which is nowproved 
to result from the local action 
on the Schneiderian mucous 
membrane of the pollen of par- 
ticular grasses, Prof. Helm- 
holtz has lately pointed out 
that quinine applied in the 
form of snuff or strong solu- 
tion [gr. j-f Jj], will effect a 
speedy cure. 



232 CINCHONA. 

the Roman Campana and in 
the tissues of the victims to 
malaria. 

Specific Action. 

Quinine has what, for want of a better explanation, we 
must call a specific control over all malarial fevers and dis- 
eases which display any periodical tendency. Gubler, how- 
ever, denies all specific influence, and believes that it acts by 
giving tone to the sympathetic nerve, thus enabling it to re- 
sist the attack of the malarial poison. Binz, on the con- 
trary, denies all neurotic explanations, and holds its effects to 
be due to its paralyzing action on the septic processes caused 
in the blood and tissues by a ferment from decaying vegeta- 
tion, whose further chemical development is thus arrested. 

Now quinine may act as a prophylactic, and, given in 
moderate doses at regular intervals, may ward off attacks ; 
and this fact is extensively taken advantage of by African 
travellers and troops stationed in malarial districts, to whom 
rations of quinine are invariably served out. When the dis- 
ease, however, is fairly developed, quinine will keep it in 
check and even arrest its progress ; and this either in smaller 
doses frequently repeated, or in one considerable dose taken 
shortly before the attack is expected. 

The periodical return of the paroxysms of shivering, heat, 
and sweating, enables us to calculate with accuracy the very 
hour of the day at which to expect their recurrence ; and 
experience has determined that the best mode of treatment is 
to give one full dose of 10 or 20 grains half an hour before 
the attack comes on. 

The remarkable enlargement of the spleen which attends 
intermittent fever is often so rapidly diminished by quinine 
as to make it probable that the reduction of bulk is due to 
an active contraction of the substance of the organ itself. 

Another curious point about the action of quinine is, that 
whilst it may check the rigors and rise of temperature 
attending the aguish paroxysm, the quantity of urinary water 
and urea excreted may be as much increased as they always 
are during the attack. 

Quinine is also an invaluable agent in some of those affec- 
tions which, without belonging directly to the aguish cate- 
gory, have som thing of the intermittent quality impressed 
on them ; for example, we often find that neuralgia and 



CINCHONA. 233 

various forms of headache are distinctly periodic, and return 
at regular intervals. In such cases quinine works wonders 
and may effect a cure with almost magical rapidity. 

Mode of Elimination. 

Quinine, being possessed of considerable diffusive power, 
rapidly enters the blood, and is rapidly given out. It may 
be found in the urine in 30 minutes after ingestion ; elimina- 
tion is at its height in 2 or 3 hours, diminishes in 24 hours, 
and ceases in three days. Although traces of its presence- 
have been found in the saliva, sweat, and intestinal secre- 
tion, it is by the urine that the greater part, probably about 
two-thirds, is given off, and according to some authorities, 
the sulphate is converted into a different allotropic form, 
partly amorphous, and quite inert, which has been called 
quinicine. 

Disadvantages of its Use. 

In addition to the headache, deafness, ringing in the ears, 
and other physiological phenomena, already noted, a good 
many cases have now been recorded of eruptions on the 
skin. In some of the quinine manufactories abroad, ecze- 
matous eruptions are observed in the workmen employed, 
and its internal administration has been occasionally fol- 
lowed by a bright-red, scarlatinoid rash, accompanied by 
intolerable itching and smarting and followed by copious des- 
quamation, or, more rarely, by a rubeoloid eruption, rather 
suggestive of urticaria, and attended with marked gastric 
derangement, a curious point being that these unpleasant 
effects have usually followed very small doses, sometimes of 
only a simple grain. Urinary irritation is also occasionally 
produced, more especially in the old, and consisting of dys- 
uria, renal congestion, and even hemorrhage. . And we must 
remember that idiosyncrasy here plays an important role, 
and that some persons cannot take a single grain without 
inconvenience. 

Therefore, as before advised, it is always well, before pre- 
scribing quinine, to ask our patient if he has ever taken it 
before. If much prostration follows a large dose, strong 
black coffee is the best remedy. 

20* 



234 CINCHONA. 



Mode of Administration and Dose. 

This salt is best prescribed in mixtures with a little nitric 
or dilute sulphuric acid, as tinctures do not dissolve it well ; 
though, as Ringer says, it is really unnecessary to combine 
acid, as the quinine is readily soluble in the acid of the gas- 
tric juice. But a little acid makes a more elegant mixture, 
by removing that turbidity which a certain quantity of the 
undissolved alkaloid necessarily imparts to a solution. The 
dose varies from about gr. j, which is the usual tonic dose, 
to 10, 20, 30 grains, or even more; and although in this 
country a larger quantity than 10 grains is perhaps rarely 
prescribed, it is clearly absurd to put the maximum dose, as 
in the British Pharmacopoeia, so low as this. 

A good way of obviating the headache and ringing in the 
ears, is by adding to each dose n^xxx of hydrobromic acid, 
which is also a good solvent. 

[As urged by Dr. Alonzo Clark, quinia may be given by 
the rectum, in the ordinary form of suppositories, with almost 
if not quite as much efficacy and promptness of action as 
when given by the mouth. When given in the usual way it 
is found that to avoid the bitter taste of quinia is absolutely 
necessary in some cases. For this purpose it is sometimes 
ordered in sugar-coated pills, or inclosed in cachets de pain. 
The powder may be given to children in a spoonful of syrup 
of red orange, or mixed with honey or molasses ; it may also 
be taken in coffee, or simply suspended in cold water, or the 
powder sprinkled over the cut surface of an orange. The 
quinia may be enveloped in tissue paper and twisted tightly 
into a ball; a little practice will enable an adult to deftly 
swallow such a bolus without tasting, and with but little in- 
convenience. The aromatic elixir of glycyrrhizin has been 
recommended as the best vehicle for the administration of 
the sulphate of quinia; 1 but preparations containing licorice, 
such as the officinal fluid extract of taraxacum, or the com- 
pound licorice mixture, or the elixir of Yerba Santa, are quite 
satisfactory for this purpose. Tannin has the power of dis- 
guising the taste of quinia, and, according to Rolander, it 
does not detract from its therapeutic properties. The fol- 
lowing formulas will be found useful for the administration of 
quinia in solution: — 



1 Remington, Med. and Surg. Rep., vol. xxxvii. p. 88, Phila., 

1877. 



CINCHONA. 




For children — 




I£. Quiniae sulphatis gr. xxiv ; or 
Acidi tannici £ij ; " 
Syr. cinnamomi f §iij ; " 

S. Capiat cochleare parvum ter in die. 


i)50 Gm. 

8 

96; 


Or, as the disulphate — 




I£. Quinine sulphatis gr. xxiv ; 

Acidi sulphurici dil. f JJj ; 

Tr. cardoinomi co. f 5Ui ; 

Syrupi q. s. ad f §iij ; 
S. Dose, f 3J. 


or 1 50 Gin. 
" 4 

" 12 " 
" 96| " 


Or, in a cough mixture — 




I£. Quiniae sulphatis gr. xxiv ; 
Acidi sulphurici dil. q. s. ad solve : 
Mist, glycyrrhizse co. ad f 3 iij ; 

S. Dose, a teaspoonful. 


or 1150 Qm. 
" 96| 



235 



M. 



M. 



M. 



In the declining stage of whooping-cough. 

For adults, any of the preceding prescriptions may be 
used, or we may give the following : — 

I£. Quiniae sulphatis gr. xlviij ; or 3,20 Gi 

Acidi sulphurici dil. q. s. ; 

Syrupi limonis f j|ij ; " 64 

Aqu» q. s. ad f'^vj ; "192 " M. 

each drachm containing one grain of quinia. A more plea- 
sant preparation would probably be obtained by substituting 
Curacoa cordial for the lemon syrup. As a tonic carmina- 
tive the following proves very acceptable in weakened 
digestion : — 

$. Quiniae sulphatis gr. xlviij ; or 3 20 Gm. 

Acidi sulphurici dil. q. s. ad solve ; 
Tr. gentian ae comp. f.^iv '; " 128 " 

Syr. zingiheris q. s. ad f gvj ; " 192 \ " M. 

S. Capiat cochleare magnum ante cibum. 

Wine of aloes may be appropriately added, should consti- 
pation be present in the case.] 

R. Quinia? sulphatis gr. viij ; or 50 Gin. 

Acidi nitrici diluti f"3 ss ; " 2 " 

Tincturae aurantii f §ss ; " 16 " 

Syrupi aurantii cort. f £j ; "32 " 

Aquas q. s. ad f § viij ; "256 " M 

S. Dose, f §j ter die sumendus. 

For a case of debility and want of appetite. 



236 CINCHONA. 

Some persons, who object to sweets, prefer the syrup to 
be left out ; but it will usually be found an agreeable addi- 
tion. Quinine may also be given in the form of simple 
powder, suspended in a glass of sherry, and when a large 
dose, such as 10 grs., is prescribed, it is more conveniently 
taken in simple suspension in distilled water. A very com- 
mon plan is to order quinine with acid infusion of roses, but 
Squire has pointed out that a turbid and unsightly mixture 
is thus produced from the resulting tannate of quinine being 
insoluble in sulphuric acid ; whereas if the infusion be made 
with nitric acid, the mixture is " bright and attractive in 
appearance." 

Under the name of Warburg's tincture, a secret prepara- 
tion of unusual complexity has recently been made public, 
and has been most highly recommended by Maclean in tropi- 
cal diseases, and by Broadbent and Playfair in cases of shock 
and collapse. Under its use free perspiration sets in, and 
the temperature goes down, and it is believed that the action of 
the drug is materially aided by the powerful aromatics with 
which it is combined and the state of concentration in which 
it is given. Each one-ounce bottle contains 9J grains of 
quinine, and it is best given on an empty stomach after pre- 
liminary evacuation of the bowels, the ounce being taken 
undiluted and repeated in 2 or 3 hours. 

Other Preparations. 

In addition to quinia other alkaloids and substances have 
been detected in bark, some of which are of use in medicine. 
We have : — 

1. Quinic or kinic acid. 

2. Quino-tannic acid. 

Quinetum is the collected alkaloids of bark, and has been 
found to be very efficacious in chronic cases of ague. 

3. Cinchona red. 

4. Kinovin. 

These four have no therapeutic significance. 

5. Cinchonia has some febrifuge power [and sulphate of 
cinchonia can in many cases take the place of quinia as an 
antiperiodic, at about one-eighth the cost.] 

6. Quinidia has been reported as nearly equal to quinine 
in the foregoing respect [and is an efficient substitute for the 
more expensive salt.] 



CINCHONA. 237 

7. Cinchonidia is only a little efficacious, but causes an 
unpleasant dryness of the mouth. 

None of these preparations have been able to completely 
take the place of quinine, as they are weaker, less certain in 
action, and less agreeable; and quinine, notwithstanding its 
comparatively high price, still retains its position as our most 
reliable antiperiodic. 

The preparations of cinchona, as we said before, are prin- 
cipally used for their tonic properties ; and there is perhaps 
no more pleasant and effectual medicine of this class than 
the ordinary tincture of bark, whilst the decoction or infusion 
is in very general use as a vehicle for more active drugs. 

The elixir of cinchona flava, though not officinal, is an 
elegant preparation, and is much used. [Dose, f'oss— ij.] 

Tinctura cinchonae composite [Huxham's tincture] con- 
tains powdered red bark, bitter orange-peel, serpentaria, 
saffron, cochineal, and proof spirit. [It is a valuable tonic 
and stomachic] 

[The bimuriate of quinia with urea is a very soluble form 
of double salt lately introduced, which has especial advan- 
tages for the hypodermatic method. 

The relative therapeutic activity of the ordinary alkaloids 
as compared with each other is thus given by Bartholow : — 

Quinidia is entitled to the first rank as an antiperiodic. 

Quinia (usually given in doses that are too small). 

Cinchonia is about one-half the strength of quinia. 

Cinchonidia is a little stronger than cinchonia. 

Quinoidine, or chiniodine (amorphous), is about one-fourth 
the strength of quinia. 

The salicylates of quinia and cinchonidia have been in- 
troduced, and are especially recommended for neuralgia. 

Chinolin. — The tartrate and salicylate of chinolin 
have been recently introduced as substitutes for the cin- 
chona alkaloids, attention having been directed to them, 
under the name of artificial quinine. 

The ordinary commercial chinolin . is a reddish-brown 
liquid, while the tartrate is a white crystalline powder. It 
often has a disgusting tobacco-like odor, due to some uncom- 
bined chinolin or to slow decomposition. Rueber 1 found 

1 [Monthly Review of Medicine and Pharmacy, translated from 
Schweizerische Wochenschrift, Xo. 49.] 



238 CINNAMON. 

that by repeated distillations of chinolin made synthetically 
according to Skraup's method (48 parts nitro-benzole, 76 
parts aniline, 240 parts of glycerine, and 200 of English sul- 
phuric acid), he obtained a colorless, transparent, oily liquid 
which remained unchanged after six months, from which a 
specimen of fine acicular crystals of chinolin tartrate was 
obtained, which possessed only a faint odor. The salt was 
insoluble in ether, soluble in 65 parts of alcohol and in 20 
parts of water at 15° C. ; but water at 100° dissolves six 
times as great a proportion ; the excess afterwards deposits 
on cooling. The author confirms the experience of Dr. 
Donath as to the value of this salt as an antiseptic, and 
asserts that it possesses no properties which would render it 
deleterious to health when used for the preservation of arti- 
cles of food. 

The tartrate of chinolin is said to have decided effect in 
periodical neuralgia and in* intermittent fever, in doses of 
one or two grammes to adults, given in wafers or cachets de 
pain ; it may be given to children in equal parts of syrup 
and distilled water. Peppermint is recommended as a vehicle 
for disguising the taste. It is said not to produce tinnitus 
or other cerebal disorder. In malaria it has proved efficient 
in some cases, but in doses larger than quinia. 

The physiological action of the tartrate of chinolin may be 
summed up as that of a decided apyretic and powerful anti- 
zymotic. Dr. Donath declares that it is superior in its anti- 
septic power to salicylic, boracic, and carbolic acids, or to 
copper sulphate and alcohol. In the proportion of 0.2 per 
cent, it arrests fermentation in milk and the development of 
bacteria ; a 0.4 per cent, solution will prevent decomposition 
of blood or the curdling of milk. When administered inter- 
nally, it has not been found in the urine, and appears to be 
decomposed in the system. As a local antiseptic, it has spe- 
cial advantages.] 



CINNAMOMUM— CINNAMON. 

[The prepared baric of Cinnamomum Zeylanicum (Nees Lauriii), and of 
Cinnamomum aromaticum {Nees, ibid., U. S. 

Oleum Cinnamomi. Dose,gtt. j-ij (.06 to .12 Gm.). 
Officinal Preparations, U. S. 

Tinetura Cinnamomi (3jss to Oj). Dose, f5j-ij 
(4. to 8. Gm.). 



COCHINEAL — MEADOW SAFFRON. 239 

Aqua Cinnamomi — as a vehicle. 

Pulvis Aromatieus (cinnamon and ginger each 2 
parts, cardamom and nutmeg each 1 part). Dose, gr. x-xx 
(.60 to 1.30 Gm.). 

Confectio Aromatiea (pulv. aromat. and honey). 

Spiritus Cinnamomi (oil §j in Oj). Dose, f5i-ij 
(4. to 8. Gm.). 

Also enters into Acidum Sulphuricum Aromaticum, In- 
fusum Catechu Compositum, Spiritus Lavandulae Compositus, 
Syrupus Rhei Aromatieus, Tinctura Cardamomi Composita, 
Tinctura Catechu, and Yinum Opii.] 

Cinnamon is principally used for flavoring purposes, but 
also seems to have slight astringent properties, which make 
it useful in diarrhoea. [It has been also strongly recom- 
mended in uterine hemorrhage, given in substance, or as a 
decoction made with milk.] 



[COCCUS— COCHINEAL. 

The female of Coccus cacti, U. S. 

It enters into Tinctura Cardamomi Composita. 

Cochineal has been considered to possess antispasmodic 
and anodyne properties, and has been recommended in 
whooping-cough (gr. J, s. t. d., to infants) combined with 
carbonate of potassium. It is also used in neuralgia. In 
pharmacy it is used as a coloring agent.] 



[COLCHICUM— MEADOW SAFFRON. 

Colehici Radix. The corm of Golchicum autumnale, 
U. S. 

Colehici Semen, The seed of Colchicum autumnale, 
U. S. 

Officinal Preparations, IT. S. 

Extractum Colehici Aeetieum (of the root), 
Dose, gr. j-ij (.06 to .12 Gm.). 

Extractum. Colehici Radicis Fluidum. Dose, 

Hi ij-iv (.12 to .24 Gm.). 

Vinum Colehici Radicis (£vj to Oj). Dose, gtt. 
x-xv (.00 to 1. Gm.). As a purgative, rr^xxx (2. Gm.). 



240 



MEADOW SAFFRON. 



Extractum Colchiei Seminis Fluidum. Dose, 
n^ij-vj (.12 to .40 Gm.). 

Tinetura Colchiei (of the seeds, $ij to Oj). Dose, 
r^v to f"5j (.30 to 4. Gm.). 

Vinum Colchiei Seminis (of the seeds, gij to Oj). 
Dose, tt^x to 5j (-65 to 4. Gm.).] 

Internal Action. 



Physiological. 

The leading physiological 
action of colchicum is un- 
doubtedly directed to the in- 
testinal canal, large doses 
causing free vomiting and 
copious purging of yellowish 
feces containing a large 
quantity of bile. The action 
of the heart is usually some- 
what depressed, and it has 
been stated that the urinary 
secretion is augmented, but 
of this there is no very clear 
proof. 

[Colchicum increases the 
proportion of the urea and 
uric acid, as well as the 
amount of urine excreted by 
the kidneys, according to 
Prof. Christison, Dr. Mac- 
lagan, and others ; but, on 
the other hand, this is denied 
by Gubler. 

The active principle is an 
alkaloid, colchicia, which is 
from 80 to 100 times stronger 
than the fresh corm.] 



Therapeutical. 

As the experiments of 
Rutherford have shown that 
colchicum increases the bil- 
iary secretion, it may be a 
useful adjunct to cholagogue 
pills, although its own purga- 
tive action is too violent to be 
available for this purpose. 

Its principal use is as a 
remedy for gout, more espe- 
cially the acuter forms, and 
here it never fails to remove 
pain rapidly, without, how- 
ever, in any way lessening 
the tendency to future at- 
tacks. How it acts is un- 
known, and we can only call 
it a specific. Some good 
authorities, however, contest 
this effect, believing it to act 
merely as a palliative ; and 
that, in order to get its full 
influence, at least 3 or 4 stools 
a day must be produced. It 
.is believed to be cumulative. 
It is also very valuable in 
various diseases of gouty 
parentage, as in some forms 
of dyspepsia, bronchitis, etc. ; 
but in acute rheumatism it 
has been proved to exert 
rather a noxious than a bene- 
ficial influence. 



COLCHICUM. 



241 



Dose and Mode of Administration. 

Colchicum may be given either in one or two full doses, 
or in smaller quantities spread over a longer time. Of these 
plans the former is probably the more effectual in an acute 
attack of gout. The following formula? are suitable for va- 
rious gouty conditions : — * 

fy. Tincturce colchici V^xx ; or l!30 Gin. 

Potassii bicarbonatis gr. x ; " 60 " 

Aqua? pimento? [Br.] f |j ; " 32( " 

Misce, fiat haustus ter die sumendus. 

I^. Tincturse colcliici ni^xv ; or 1 Gm. 

Magnesii carbonatis gr. vj ; " 40 " 

Magnesii sulpliatis gr. xxx ; tl 2 

Aqua? nientha? piperita? q. s. ad f Jj ; " 32 

S. Pro dosa, ter die sumendus. 



M. 



m. Ammonii carbonatis gr. xl. 


or 


2 


60 Gin. 


Sodii bicarbonatis 3iss 


(< 


6 




Tincturse colcliici f 3ij ; 


c< 


8 




Syrupi aurantii f 5iv : 


ti 


16 




Aquse q. s. ad f.^viij ; 


a 


256 




S. Capiat unciam bis in die. 






P^. Extracti colcliici acetici gr. x ; 


or 




65 Glm. 


Pulveris digitalis, 








Extracti colocynthidis comp. aa 9 j ; 


it 


1 


30 " 


Misce, fiant pilule xx. Suniat unam bis terve in die. 


I£. Potassii iodidi, 








Ammonii carbonatis aa 9j ; 


or 


1 


30 Gm. 


Vini colchici f 3j ; 


(< 


4 


n 


Tincturse scillse, 








Tincturse liyoscyami, aa f 3 ij ; 


it 


8 


it 


Aquas camphora? q. s. ad f^iij ; 


it 


96 


a 



M.] 



M. 



S. f^ss ter die. 

Dr. Greenhow's formula for gouty bronchitis. 

[Scudamore's mixture : — 



B 


Magnesii sulpliatis 


i.i-ij ; 


or 


321 




Magnesia? 


3ij, gr. xl; 


it 


10 




Aceti colchici [Br.] 


f 5Hss ; 


tt 


32 




Syrupi croci [Br.] 


f?i; 


it 


32 




Aqua? nientha? pip. 


fix; 


a 


320 



60 



; < M. 
Dose, ffss-jss repeated every 2 hours in a paroxysm of gout 
until from four to six evacuations are produced in tlie 24 hours. 

The Acetum colchici was omitted from the Pharmacopoeia 
in the last revision. It was made from the corm, and was 
21 



242 



COLLODION. 



only one-third the strength of the officinal wine of colchicum 
root. In making preparations the fresh seed should be used 
(Mols), as the old seed and its preparations are less active ; 
some samples of fluid extract contain no colchicia at all.] 
By contact with acids, even those of wine or vinegar, colchi- 
cine is transformed into colchiceine, a neutral glucoside of 
very inferior strength ; and alcohol, which has no such con- 
verting power, is therefore the best solvent. 



[COLLODIUM—COLLODION. 

Pijroxylon dissolved in ether and alcohol. 

Collodium cum Cantharide. Blistering Collodion. 
Collodium Flexile. Flexible Collodion.] 

Collodion is used to fulfil two indications : — 



1. To exclude the action 
of the air from inflamed parts, 
and to prevent the patient 
from scratching and irritating 
the surface. 



2. To exert a moderately 
constringent effect, from the 
contraction which follows its 
drying. 



1. For this purpose it is 
used to paint over the pus- 
tules of smallpox, in the hope 
of preventing pitting. Also, 
in herpes zoster and in ery- 
sipelas it may be applied 
with advantage. 

2. Dr. Hare tells us that, 
at the very early or papular 
stage of a boil, we may avert 
subsequent suppuration by 
the application of collodion. 
[In the early stage of a boil 
it may be aborted by touch- 
ing the top with a drop of 
cantharidal collodion.] 

Sir D. Corrigan recom- 
mends sealing up the ex- 
tremity of the prepuce by 
collodion to remedy the 
nocturnal form of inconti- 
nence of urine in children ; 
and it may be of service in 
hemorrhage depending on 
capillary oozing, and more 
especially in the troublesome 



BITTER CUCUMBER, 



243 



bleeding frequently following 
leech-bites. 
[Styptic colloid, as it is Finally, its application 
called, instantly coagulates may facilitate the healin: 



blood, and wounds heal read- 
ily under its protection. 1 ] 



process in small cuts and 
wounds, as after the ops- 
ration for harelip, and in 
the troublesome condition 
known as cracked nipples. 
Under all these conditions 
the best results may be ob- 
tained by using the flexible 
collodion, in which the com- 
bination with castor oil pre- 
vents the too rapid cracking 
or peeling away of the pro- 
tecting film. 



COLOCYNTIIIS— BITTER CUCUMBER. 

[7 Vie fruit, deprived of its rind, of CitruUus Colocyntkis, U. S. 

Offictnal Preparations, U. S. 

Extraction Colocynthidis (alcoholic). Used only 
in combination. Dose, gr. ij-v (.12 to .30 Gm.). 

Extraetum Colocynthidis Compositum. Dose, 
gr. v-xxx (.30 to 2. Gm.). 

Pilule Cathartic© Composite. Dose, 1-3 pills.] 



Physiological Action. 

Colocynth produces a good 
deal of irritation of the large 
intestine, causing profuse 
watery evacuations, and, if 
given in excessive dose, even 
proving fatal by inflammation 
and ulceration. It is found, 
however, that its drastic ac- 



Therapeutical Action. 

Colocynth is a drastic pur- 
gative, rapid and efficient in 
its action, and much used 
as an ordinary remedy in 
habitual constipation and 
various dyspeptic conditions. 

Rutherford's recent experi- 
ments have proved colocynth 



1 [Styptic colloid is made by adding to collodion (100 pts.) ; car- 
bolic acid (10 pts.) ; tannin (5 pts.) ; and benzoic acid (5 pts.). — 
Proc. Am. Pharm. Assn., 1881, p. 0*4.] 



244 HEMLOCK. 

tion, as well as the griping to to be a powerful stimulant 
which it occasionally gives both of the hepatic secretion 
•rise, may be obviated by and of the intestinal glands, 
combination with aromatics 
and other purgatives. 

Mode of Administration. 

Colocynth is rarely, if ever, prescribed alone. The offi- 
cinal compound extract or pill, containing, in addition, aloes 
and scammony, is a useful formula ; but the best mode of 
combination is undoubtedly that with either hyoscyamus or 
belladonna. 



[Confeetiones. 

The officinal Confections are: — 

Confectio Aromatica Confectio Ros?e 

" Aurantii Corticis " Sennse.] 

" Opii 



CONIUM—HEMLOCK. 

[Conii Folia. The leaves of Conium maculatum, IT. S. 
Conii Fruetus. The full-grown fruit of Conium macu- 
latum, gathered while yet green and carefully dried, U. S. 

Officinal Preparations, U. S. 

Extractum Conii Fruetus Fluidum. Dose, 
nrj-v (.06 to .30 Gm.). (Seguin says that much larger doses 
are often well borne.) 

Extractum Conii (of the leaves). Dose, gr. j-iv (.06 
to .25 Gm). 

Extractum Conii Aleoholicum (of the leaves). 
Dose, gr. j-ij (.06 to .12 Gm.). 

Suceus Conii. 1 Dose, f 5ss-j (2. to 4. Gm.). 

Tinetura Conii (5ij to Oj). Dose, f 5ss-j (2. to 4. 
Gm.). 

Test Methyl-conia, the active principle of conium, when 

liberated from its combinations by potassa, is volatile, and 

1 [A very uncertain preparation as commonly dispensed.] 



HEMLOCK. 



245 



exliales a strong mouse-like or urinous odor. With the vapor 
of muriatic acid, it forms dense white fumes. The odor of 
conia is so characteristic, that it can scarcely be confounded 
with any other poisonous agent. 

Antidote. 
Atropia has been suggested as a physiological antidote.] 

Local Action. 

Conium has been occasionally used in the form of poultice 
as an application to cancerous sores or tumors, and it is said 
that the severe lancinating pain common to these affections 
may thus be mitigated. 



Internal Action. 



Physiological. 

1. On Nervous System 

1. Brain No effect is pro- 
duced on the brain proper, 
it having been observed in 
cases of poisoning, and 
notably in that of Socrates, 
and in a patient under Prof. 
Bennett's care, that the in- 
tellectual faculties are quite 
unimpaired to the last. 

Dr. John Harley, however, 
is of opinion that a consider- 
able portion of the action of 
conium is expended on the 
motor ganglia, and more es- 
pecially the corpus striatum. 

2. Spinal Cord Pure 

conium has no special influ- 
ence on the spinal nervous 
system, but an alkaloid, 

METHYL-CONIA, which it 

usually contains, has been 
proved to cause first exalta- 
tion, and finally depression, 
of the reflex function of the 
cord. [Dr. Christison thinks 

21 



Therapeutical. 



I. To this action Dr. Har- 
ley ascribes the beneficial in- 
fluence of conium in chorea. 
Although in many cases we 
may derive real advantage 
from this remedy, it often 
fails, and in order to insure 
the full amount of benefit we 
must use large doses, and see 
that the drug is pure. Dr. 
Harley also recommends it in 
the nervous twitchings met 
with in some cases of hemi- 
plegia. Conium has been 
given with some benefit in 
the convulsions of children. 



246 



HEMLOCK 



" that it acts upon the spinal 
marrow, directly prostrating 
the nervous power, producing 
paralysis of the voluntary 
muscles, and destroying life 
by arresting respiration."] 

3. On the Nerves. — Herein 
lies the true physiological 
action of conium. It acts 
first on the third nerve, 
causing drooping of the eye- 
lid, dilatation of the pupil, 
and sluggish and impaired 
movement of the eyeball. 
The influence then spreads 
to all the other motor or 
afferent nerves. A sensation 
of weight and enfeeblement 
of the legs, followed by stag- 
gering, is first experienced, 
and finally total paralysis is 
developed, the victim being 
entirely unable to move; and 
so complete may this become, 
that asses in Italy which have 
fed on hemlock have been 
flayed alive without the pos- 
sibility of resisting in any 
way. This paralyzing influ- 
ence is at first confined to 
the terminal extremities of 
the nerves. 

The sensory nerves are 
quite unaffected. 

II. Vascular System. — 
No effect is produced on the 
heart or circulation. 

III. Respiration and Tem- 
perature The breathing is 

at first unaffected, but, as the 
poisonous action of the drug 
goes on, the paralysis spreads 



[From 10 to 15 drops of 
the alkaloid has caused 

death.] 



3. Dr. Harley recom- 
mends its use in the violent 
spasm of the orbicularis met 
with in keratitis, but I have 
been unable to confirm this 
after careful trial. 

The remarkable power of 
conium in effecting muscular 
relaxation would indicate its 
use in a variety of spasmodic 
conditions. Thus, in laryn- 
gismus stridulus, trismus, 
spasmodic ivry neck, spas- 
modic stricture [hysteria, 
and insanity~\, and perhaps 
in the reduction of hernia 
and dislocation where any 
contra-indication to the use 
of anaesthetics exists, it seems 
worthy of trial ; and Dr. 
Handfield Jones recommends 
it highly in paralysis agi- 
tans. It must, however, be 
confessed that the therapeu- 
tical success of conium by no 
means comes up to its phy- 
siological promise. [Dr. 
Seguin, of New York, ex- 
plains its failure by the small- 
ness of the quantity usually 
ordered. In chronic convul- 
sive disorders he gives as 
much as a drachm at a dose 
and never less than twenty 
minims for adults. In the 
latter amount he gives it as 



HEMLOCK. 247 

to the respiratory centre, and an indirect hypnotic, in com- 

death ensues from asphyxia, bination with bromide of 

Some lowering of the tern- potassium. From these truly 

perature has been observed, extraordinary doses of the 

IV. Secretion No influ- fluid extract he claims never 

ence on secretion has been to have had any serious or 
noted. threatening symptoms pro- 

duced.] 

Dr. Crichton Brown has 
seen good results from the 
use of conium in mania with 
violent motor excitement, in 
which it restrains the violent 
muscular movements ; and 
Dr. R. Burman has used 
conia by subcutaneous injec- 
tion successfully in the same 
class of cases. 

Mode of Elimination. 

The presence of conium has been detected in the blood, 
and its elimination is effected by the breath and urine, but 
principally by the latter. 

Mode of Administration, Cautions, etc. 

It having been satisfactorily proved that the succus is the 
only reliable preparation of hemlock, it is not necessary for 
us to say anything about the tincture, extract, vapor, or com- 
pound pill. Unfortunately, however, it is often difficult to 
obtain an efficient succus, as it keeps ill, and cannot always 
be satisfactorily made. This is no doubt due to the fact of 
the cultivated plant being used, which is quite inert. Dis- 
appointments frequently occur both from this cause and from 
the smallness of the dose often given in accordance with the 
recommendation of the Pharmacopoeia. In order to obtain 
any decisive effect we must give of some preparations, as 
much as from half an ounce to 3 or even 4 ounces, as has 
been done by Dr. Harley, remembering that the limit of 
safety is reached when any interference witli involuntary 
movement is observed, this being best indicated by enfeeble- 
ment of deglutition. 

Children bear conium remarkably well. I have given 
ounce doses to a girl of eight, and the late Dr. Anstie pre- 



248 COPAIBA. 

scribed even larger quantities to a younger child, without 
the slightest development of physiological symptoms. [On 
account of the uncertainty of the strength of juice, it is best 
to begin with small doses, and carefully increase them until 
some paralytic effect is produced. Death has been caused by 
150 minims of Squibb's fluid extract. Attention has been 
called by Dr. Squibb to the danger of diluting the fluid ex- 
tract, for a precipitate may be formed containing the active 
principle, and by this means a poisonous dose may finally be 
given. He had seen serious symptoms but never fatal acci- 
dent from this cause Trans. Med. Soc. State of New York, 

1882. 1 ] 

The alkaloid conia has been occasionally used by subcuta- 
neous injection, but is objectionable from being very variable 
in strength. When injected pure it is not only quite inert 
(therapeutically) but very irritating (John Harley), and the 
addition of acetic or hydrochloric acid is necessary to insure 
physiological action. 

For Hypodermic Injection. 



R. Conise giij, ntxij ; or 12 


80 Gm. 


Acid, acetic, fort. 3 i i j s s ; "14 


" 


Spt. vin. rect. f gj ; " 4 


Cf 


Aquae destillat. q. s. ad f 31J ; " 64 


" M. 


Five minims of this solution contain one minim of the alka- 


loid, the dose being -^ to i of a minim. [The dose of 


Conia is about gr. -J^.] 





COPAIBA— COPAIBA. 

[ The oleo-resin of Copaifera multijuga (Hayne) and of other species of 
Copaifera, U. S. 

Dose, ni^xv to 5j (1 to 4 Gm.). 
Officinal Preparations, U. S. 

Oleum Copaibae. Dose ir^viij-xv (.50 to 1 Gm.). 
Pilulse Copaibse (each contains gr. ivss). 3-5 pills.] 

Local Action. 

Pit ys iologic a I. Therap e u tical. 

Copaiba locally applied It has been used in this 

seems to act as a slight way in certain obstinate af- 

stimulant to the skin. fections of the skin, such as 

[i Medical News, 1882, p. 164.] 



COPATBA. 



249 



psoriasis ; and in India it 
seems to have been employed 
with some success in leprosy 
and lupus, bearing as it does 
a considerable analogy to the 
gurjun oil which has lately 
acquired so high a reputation 
in the treatment of the first- 
mentioned disease. Its nau- 
seous smell, however, must 
always be a serious barrier to 
its use. 



Constitutional Actions. 



1. Brain and Nervous 
System No influence is ex- 
erted by copaiba on the brain, 
spinal cord or nerves. 

II. Heart and Circula- 
tion. — No effect is produced 
on these organs, or on the 
respiration and temperature. 

III. Digestive and Secret- 
ing Organs 1. Stomach 

and Intestines. — Copaiba fre- 
quently causes most violent 
vomiting and purging. 

2. It has a stimulating ef- 
fect on mucous membranes 
generally, but more especi- 
ally on those of the genito- 
urinary tract, in virtue of 
which, after slight prelimi- 
nary irritation, it checks and 
finally arrests excessive dis- 
charges. 

3. Kidneys. — Copaiba, and 
more particularly the resin, 
increases very considerably 
the water of the urine with- 
out specially affecting the 
solid constituents. 

4. Copaiba, by internal 



Copaiba is an excellent 
remedy (1) in gonorrhoea, 
where it may be given with 
great effect as long as the 
discharge continues thick 
and puriform. When the 
earliest inflammatory symp- 
toms have been subdued by 
alkalies and diluents, it will 
prove our best remedy, and 
it seems to act neither purely 
locally nor constitutionally, 
but in both ways conjointly, 
being altered in some way in 
the blood, and then exerting 
a topical influence on the 



250 COPAIBA. 

administration, seems to stira- affected mucous tract. (2) 
ulate the skin, and occasion- It is also of service in chronic 
ally produces an eruption of cystitis, and in the later stages 
bright red papules, not un- of bronchitis, when profuse 
like measles, usually begin- and exhausting discharges 
ning on the hands, spreading have been established from 
over the body, and causing the bronchial tubes. (3) 
much tingling and itching. As a diuretic, the resin has 

been most highly praised by 
Dr. Wilks and Dr. F. Taylor 
in the dropsy of heart disease, 
in ascites, and in some forms 
of renal affections. (4) Dr. 
Liveing, more especially, has 
drawn attention to the value 
of copaiba in psoriasis and 
other obstinate skin diseases. 

Absorption and Mode of Elimination. 

Copaiba is very rapidly absorbed into the blood, as indi- 
cated by the communication of its nauseous smell to the 
breath and urine, by which channels it is principally elimi- 
nated. On the addition of nitric acid to the urine of patients 
taking copaiba, a milky appearance is produced by precipi- 
tation of the resin, and this is distinguished from albumen by 
the action of heat, which melts the resin and removes the 
deceptive cloud. 

Peculiarities. Mode of Administration. 

The digestive disturbance occasionally caused by copaiba 
prevents some persons from taking it at all, and the almost 
invincibly nauseous nature of its flavor and odor is a serious 
drawback to its use. Capsules both of sugar and gelatine 
have been devised, which are frequently well borne; but we 
must remember not only that these are often too large to be 
swallowed with comfort by nervous persons, but that their 
use is apt to be followed by disagreeable eructation. No 
means have been proposed to obviate the measly and irritable 
rash which not unfrequently appears on the skins of patients 
under the influence of copaiba ; but various forms of pre- 
scriptions are in general use, and some of these are mode- 



GOLDTHREAD — CORIANDER. 



251 



rately effectual in concealing the offensive flavor of this useful 
drug. 



^. Copaiba? f 5«s ; 

Liquoris potassa? f 5 SS '■> 
Misce, agitando, et adde — 

Mucilaginis acacia? 13 ij ; 

Spiritus setheris nitrosi f £ss ; 

Tiiicturse opii tt\,v ; 

Aqua? mentha? pip. q. s. ad f ^j ; 
Fiat liaustus ter die sumendus. 

For gonorrhoea. 



5- 



S. 



Copaiba? 

Syrupi tolutani 

Pulveris acacia? 

Acidi sulpliurici aromat. 

Aqua? destillata? 

f §ss ter in die. 



f§ss; 

f^ss; 

§ss ; 

t'Sss; 



For gonorrhoea. 



IJ. Resina? copaiba? 5"J '■> 

Alcoliolis f5 v 5 

Chloroformi f 5j ; 

Mucilaginis acacia? f§ij ; 

Aqua? q. s. ad f§xij ; 

S. Capiat semunciam ter in die. 

Formula for copaiba as a diuretic. 



30 



32 



16 

16 

16 

2 

192 



12 

20 

4 

64 

384 



Gm. 



Gm. 



M. 



M. 



M. 



[COPTIS— GOLDTHREAD. 

Coptis trifolia, U. S. 

Goldthread is an indigenous bitter tonic resembling 
quassia, for which it may be substituted. It may be given 
in substance (gr.x-xxx, or .60 to 2. Gm.), or infusion (oj-Qj) 
(dose, f'oj-ij, or 32. to 64. Gm.), or tincture (^j-Oj) (dose, 
f 5j-ij? or 4. to 8. Gm.). It contains berberina, but no tannin 
nor gallic acid, being a simple bitter without astringency.] 



[CORIANDRUM— CORIANDER. 

The fruit of Coriandrum Sativum, U. S. 

Enters into Confectio Senna?, Infusum Gentiana? Com- 
positum, Infusum Senna?, and Tinctura Rhei et Senna?. 



252 DOGWOOD — SAFFRON. 



Uses. 



Coriander seed is aromatic and stomachic (dose, 9j to §j, 
1.60 to 32. Gm.) ; it is rarely used except in combination.] 



[CORNUS FLORIDA—DOGWOOD. 

The bark of Comas Florida, U. S. 
Officinal Preparations. 

Decoetum Cornus Floridae. Dose, fgij (64. Gm.). 
Extractum Cornus Floridae Fluidum. Dose, f3ss 
(2. Gm.). 

Dogwood is an indigenous, astringent tonic, and has been 
recommended as an antiperiodic as a substitute for cinchona.] 



CREASOTUM— CREASOTE. 

{A peculiar substance obtained from icood-tar, U. S. 

Officinal Preparations, U. S. 

Aqua Creasoti (^iijf to fsj). Dose, fjss-iv (2. to 
16. Gm.). 
Unguentum Creasoti (f 5ss to lard ^j).] 

This drug [dose, gtt. i-ij (.06 to .12 Gm.), diluted] is now 
but little used [owing to the difficulty of obtaining it pure, 
the commercial article being largely contaminated with cre- 
sylic or carbolic acid ;] but is a useful remedy in some forms 
of sickness and vomiting, as -an inhalation for ozcena and 
various lung diseases with fetid expectoration, and as a 
local application in toothache. 

The mistura creasoti [Br.], containing ny to the ounce, 
is a convenient mode of administration. [The ointment is 
used in scaly eruptions.'] 



[CRETA— CHALK. 

Native friable carbonate of calcium, U. S. {for preparations, see 
Calcium) . ] 



[CROCUS— SAFFRON. 

The stigmas of Crocus sativa, U. S.~\ 
Saffron is never used, save as a coloring agent. 



CUBEB — COPPER. 253 



CUBEBA— CUBEB. 

[ The unripe fruit of Cubeba officinalis (Miquel), Piper Cubeba 
(Linn.), U. S. 

Dose of the powder, gr. xx to 5ij (1-60 to 8. Gm.). 

Officinal Preparations, U. S. 

Extraetum Cubebse Fluidum. Dose, f^ss— ij (2. 
to 8. Gin.). 

Oleo-Resina Cubeba^ (8 times the strength of the 
powder). Dose, n^x-xxx (.60 to 2. Gm.). 

Oleum Cubebae. Dose, gtt. v-xij (.30 to .80 Gm.). 

Tinctura Cubeba^. Dose, fjss-ij (2. to 8. Gm.). 

Troehisci Cubeba^ (each contains gtt. j of the oleo- 
resin).] 

Physiological Action. Therapeutical Action. 

Cubebs also has a stimu- Cubebs is occasionally used 
lating action on mucous mem- in cystitis, but it has long 
branes, and more particularly been known as one of the 
on that of the bladder and most efficient and generally 
urethra. In large doses it prescribed remedies for gon- 
causes considerable eastro- orrhcea, acting best during 
intestinal irritation. the acute stage of the disease. 

It has also been found use- 
ful when given in the form 
of lozenges for the relief of 
relaxed sore-throat. 



CUPRUM— COPPER. 

[Cupri Subaeetas. Impure subacetate of copper, 
U. S. 

Cupri Sulphas. Sulphate of copper, U. S. 

Cuprum. Copper wire, U. S. 

Copper is used in preparing Sp. xEtheris Nitrosi. 

Officinal Preparation, U. S. 

Cuprum Ammoniatum. Dose, gr. J-i (.015 to .03 
Gm.). 

22 



254 copper. 

Poisoning. 

The salts of copper in large doses cause vomiting, pain in 
the bowels, cramps in the lower extremities, a strong cop- 
pery taste, diarrhoea, convulsions, palsy, insensibility, and 
death. Marks of inflammation in the stomach and intestines 
are often noticed after death. When the case has been pro- 
tracted, there is often a green tinge of the lining membrane, 
and a jaundiced appearance of the skin. 

Tests. 

The sulphate in a solid state presents a bright blue color, 
and leaves an astringent metallic impression on the tongue. 
When in solution the transmission of sulphuretted hydrogen 
affords a brownish-black (sulphuret of copper) precipitate. 
Solution of ammonia precipitates a blue substance, which, on 
further addition of ammonia, becomes dissolved ; but when 
only a small amount of the poison is present, no precipitation 
occurs, a clear violet-colored solution being then at once pre- 
sented. Ferrocyanide of potassium throws down a reddish- 
brown (ferrocyanide of copper) precipitate. A piece of pol- 
ished zinc or iron (as the blade of a table knife) acquires a 
plating of copper, if placed in a liquid containing the above 
salt. 

The tests for the acetate are the same as the preceding, 
except the last. 

The ammonio-sulphate has a brilliant violet-blue color, 
and ammoniacal odor. Solution of arsenious acid produces a 
fresh apple-green precipitate. 

Antidotes. 

Albumen, ferrocyanide of potassium, followed by prompt 
evacuation of the stomach. Vomiting should be promoted by 
copious draughts of warm water, milk, or mucilaginous fluids. 
Sugar was formerly recommended. Albumen and milk form 
an insoluble compound with copper, provided they are in large 
excess. The protosulphuret of iron, and iron filings, have 
also been employed with advantage ; but their action is too 
slow. The hydrated oxide of iron has been successfully ad- 
ministered where the arsenite of copper has been taken.] 



COPPER. 



255 



Local Actions. 



Physiological. 

Copper has caustic astrin- 
gent properties both in sub- 
stance and in solution. 



Internal Act 

Physiological. 

1 . Brain and Nervous Sys- 
tem. — Copper probably acts 
in some measure as a nervine 
tonic, but when given in 
larger doses peculiar symp- 
toms set in, not unlike those 
of lead poisoning, and con- 
sisting of headache, neural- 
gic pains, cramp, and even 
paralysis. 

2. Circulation and Respi- 
ration No special effect. 

3. Secreting Organs. — 
Copper causes prompt and ef- 
fectual evacuation of the con- 
tents of the stomach, acting 
as a direct emetic. It has an 
astringent influence over the 
stomach and intestines, and 
this, if pushed too far, may 
end in gastro-enteritis. 



Therapeutical. 

In the form of the familiar 
blue-stone, or sulphate of cop- 
per, it is used as an applica- 
tion to venereal sores, ulcers 
in the throat, granular lids, 
to check exuberant granula- 
tions, etc. ; and in solution it 
is a good lotion for various 
ulcerative surfaces, gleet, etc. 

ions and Uses. 

Therapeutical. 
1. Copper has been used in 
small doses in chorea, epi- 
lepsy, etc., but with no spe- 
cially marked benefit, and it 
has been recommended lately 
in small doses, as an excellent 
tonic in defective nutrition. 



3. Copper is not so much 
used, however, for an emetic, 
as sulphate of zinc, because, 
if by any chance it be not re- 
jected by vomiting, it is liable 
to cause inflammation of the 
stomach. 

Sulphate of copper is a 
good astringent in advanced 
and obstinate diarrhoea. 



Mode of Elimination. 

Copper is eliminated chiefly by the liver and kidneys, the 
intestinal canal, and the salivary glands. 



256 FOXGLOVE. 

Method of Administration. 

As already seen, copper may act as a poison by causing 
inflammation of the stomach and intestines, as well as remote 
nervous symptoms. 

Sulphate of copper is the only salt of the metal used in 
medicine, and may be prescribed as follows: — 

^.. Tnpri sulphatis, 

Pulveris opii, aa gr. ss ; or 103 6ra. 

Extractum gentian re gr. iij; " |20 " M. 

Misce, fiat pilula? nocte maneque sumenda. 

In a case of obstinate diarrhoea. 

[As an emetic, sulphate of copper is given in doses of gr. 
ij-v (.12 to .30 Gin.).] 



[Decocta. 

The officinal Decoctions are — 

Decoct urn Cetrariae Decoctum Hamiatoxyli 

" Chimaphilae " Hordei 

" Cinclionse* Flavae " QuercusAlba? 

" Cinchona? Rubra? " Sarsaparilla? Coinp. 

" Covnns Floridse " Senega? 

" Dulcamara? " Uvae Ursa.] 



DIGITALIS— FOXGLOVE. 

[ The leaves of Digitalis purpurea, from plants of the second year's 
growth, U. S.) 

Dose, in substance, gr. ss-ij (.03 to .13 Gm.). 
Officinal Preparations. 

Extractum Digitalis. Dose, gr. \-\ (.01 to .03 
Gm.). 

Extractum Digitalis Fluidum. Dose try-ij (-06 
to .12 Gm.), 

Infusum Digitalis (3u to Oj). Dose, f3ij-iv (8. to 
16. Gm.). 

Tinctura Digitalis (^ij to Oj). Dose, n^v-x (.30 to 
.60 Gm.). 

Digitalinum 1 (active principle). Dose, gr. ^ (.001 
Gm.)]. 

f 1 The investigations of Homolle demonstrated that the officinal 
digitalin is a mixture of several compounds of which digitoxin is 
crystallizable, and is the most active constituent.] 



FOXGLOVE. 257 



Poisonous Effects. 

Digitalis kills by tetanizing the heart muscle, causing rapid 
and irregular action, followed by arrest of action. The face 
grows pale, the pupils dilate, vomiting and diarrhoea super- 
vene, and death usually occurs by syncope. Cases of poison- 
ing, however, are rare, and most of our knowledge under this 
heading has been derived from experiments on animals. 

Antidotes. 

After evacuation of the stomach and the administration of 
tannin, we must obviate the tendency to death by stimulants, 
and by keeping the patient rigidly to the horizontal posture, 
as syncope is readily excited by suddenly sitting up. 

Aconite and atropia have been recommended as physio- 
logical antidotes, but we have as yet no evidence of their 
efficacy. 

Local Action. 
Physiological. Therapeutical. 

Digitalis has been said to Digitalis has been used as 
possess sedative properties a local sedative in cases of 
when locally applied, and joint inflammation ; and the 
there is no doubt that it is application to the legs of 
rapidly and efficiently ab- spongio-piline soaked in a 
sorbed by the skin. strong infusion has been found 

to produce diuresis where 
other remedies have failed. 

Constitutional Action. 

I. Brain and Spinal Cord. I. Although no direct ac- 
— On the brain no direct ef- tion is produced on the brain 
feet is produced, but the re- tissue, it is reasonable to sup- 
flex irritability of the spinal pose that some alteration in 
cord seems to be somewhat cerebral function may follow 
lessened under the toxic ac- the alterations in the vascular 
tion of the drug. system produced by digitalis, 

Stimulation of some por- and perhaps this may in part 

tions of the vaso-motor and explain the remarkable re- 

pneumogastric nerves seems suits obtained by Mr. Jones, 

to take place, as we shall ex- of Jersey, in the treatment of 

22* 



258 



FOXGLOVE. 



plain more fully when treat- 
ing of the influence of digi- 
talis over the heart. 



II. Heart and Circulation. 
— Digitalis exerts a decided- 
ly tonic and strengthening in- 
fluence on the heart, render- 
ing its beat slower and more 
forcible, and lengthening the 
period of systole. This result 
seems to depend partly on a 
direct action on the heart's 
muscle itself, but also in some 
degree on stimulation of the 
cardiac inhibitory fibres of 
the vagus, which thus hold 
more forcibly in check the 
rapid rate of pulsation pro- 
duced by the sympathetic 
nerves. If, however, the ad- 
ministration of the remedy 
be too long continued, ex- 
haustion of the pneumogas- 
tric is apt to follow this over- 
stimulation, and the heart, 
being now handed over to 
the unrestrained power of the 
vaso-motor nerve supply, runs 
riot in excessively rapid and 
feeble contractions. 

The tonic influence of digi- 
talis is attended by well- 



delirium tremens by the use 
of this drug. He found that 
half-ounce doses of the tinc- 
ture quieted the delirium, 
reduced fever, and caused 
sleep. But this treatment 
can hardly be recommended, 
as several sudden deaths have 
been thus produced, and as 
it seems not improbable that 
the absence of toxic effects 
in many cases is due to the 
very partial absorption of the 
remedy. 

II. The undoubted effect 
of digitalis in slowing and 
strengthening the action of 
the heart, would seem to in- 
dicate its use in certain dis- 
eased conditions of the organ, 
but it is only recently that 
this tonic influence has been 
recognized. In former years 
digitalis was looked upon as 
essentially a cardiac sedative, 
and was used to quiet the tu- 
multuous palpitation of hy- 
pertrophy ; but we now know 
that it may be prescribed 
with much greater success 
under the following circum- 
stances : — 

1. In palpitation and ir- 
regular action of the heart, 
whether depending on organic 
disease or not, an important 
indication for its use being in- 
termittence, or the occurrence 
of frequent beats which do not 
reach the pulse. 

2. In mitred disease, where 
the cardiac action is feeble, 
and apparently unable effect- 



FOXGLOVE. 



259 



marked rise of arterial ten- 
sion, and this is supposed to 
depend on stimulation of the 
sympathetic centres directly 
supplying the smaller vessels; 
and at the same time the heart 
is induced to act more power- 
fully, to overcome the in- 
creased resistance in front. 



ually to propel the blood, 
where lividity and dropsy are 
setting in, the lungs becom- 
ing engorged, and the right 
heart oppressed. 

Here we shall derive the 
most signal service from digi- 
talis given in moderate doses, 
and combined with a little 
iron. Dr. B. Foster ascribes 
some of the good effect of 
digitalis in mitral disease to 
its slowing action, giving 
more time for the auricle to 
empty itself fully of its con- 
tained blood. 

The contracting effect of 
digitalis on the arterioles 
would naturally suggest its 
use in hemorrhage, and it has 
accordingly been found of 
service both in hcemoptysis 
and menorrhagia, although 
in neither is it so efficacious 
as ergot. 

3. In dilatation of the 
heart, where the weak and 
thin muscle acts feebly and 
irregularly, giving rise to pal- 
pitation and breatlJessness, 
and causing temporary bruits 
by unequal and ineffectual 
closure of the mitral and tri- 
cuspid valves. 

4. In aortic disease, when 
compensation has not been 
made complete by hyper- 
trophy. 

In short, we may use digi- 
talis whenever the heart is 
acting feebly and irregularly, 
but by its use we cannot ex- 
pect to spur on a normally 



260 



FOXGLOVE. 



III. Respiration and Tern- 

perature On respiration no 

effect is produced, and al- 
though, in a state of health, 
digitalis does not lower the 
body heat, it undoubtedly 
possesses this influence over 
febrile conditions, Wunder- 
lich and others bringing am- 
ple evidence to prove its 
power of reducing tempera- 
ture in pneumonia, enteric 
fever, acute rheumatism, and 
other acute disorders. 

Bing holds that digitalis 
is no trustworthy antipyretic, 
as its action does not begin 
for thirty-six to sixty hours 



constituted heart with sound 
, muscle to overcome difficul- 
ties in front, and we must 
avoid its regular use in the 
compensatory hypertrophy of 
aortic disease, and in fatty 
degeneration, where its tight- 
ening effect on the smaller 
vessels throws an injuriously- 
increased amount of work on 
the structurally-damaged or- 
gan. 

5. Ringer has drawn atten- 
tion to the beneficial action 
of the temporary use of digi- 
talis in relieving the distress- 
ing attacks of palpitation so 
often due to hypertrophy of 
the heart. 

G. Clifford Allbutt believes 
it to be the best remedy for 
aneurism, given in increasing 
doses, till the pulse comes 
down to 45, and continued as 
long as possible. 

III. Digitalis has been 
found of great service in those 
cases of bronchitis which are 
so frequently associated with 
a weak and dilated right 
heart, and where stimulation 
of the cardiac muscle leads to 
a better arrangement of cir- 
culation through the lungs. 

For the reduction of tem- 
perature, digitalis is seldom 
used in this country, but in 
Germany its antpyretic vir- 
tues are prized. It seems, 
however, to lower the body 
heat without influencing the 
course of the disease ; and as 
it must be given in large 



FOXGLOVE. 



2G1 



(Traube), and as it is uncer 
tain and disturbs digestion. 



IV. Digestive and Secret- 
ing Organs. — 1. Stomach 

and Intestines From its 

bitter taste, digitalis might 
be credited with some tonic 
properties ; but it is really 
much more likely to disorder 
than to increase the appetite, 
by causing vomiting. 

It does not seem to affect 
the intestinal tract in any 
way, save in the later stages 
of poisoning, when diarrhoea 
may supervene. 

2. Kidneys. — Digitalis in- 
creases, under certain condi- 
tions, the flow of urine with- 
out altering in any essential 
respect the quantity or pro- 
portion of its solid ingredi- 
ents. Its diuretic action de- 
pends partly on the tightening 
effect on the arterioles, rais- 
ing the blood pressure in the 
renal glomeruli, and partly 
on the increased power and 
regularity of the heart, im- 
proving the general condi- 
tion of circulation within the 
kidneys. One curious point 
in this connection is, that di- 
gitalis will seldom produce 
diuresis in healthy persons, 
but always acts best when 
dropsical accumulations have 
to be removed. 



doses, which may derange the 
digestive functions, even if 
they do not prove directly 
dangerous, there does not 
seem to be any real benefit 
following its employment. 



2. Digitalis is a good diu- 
retic, more especially in car- 
diac acute and renal dropsy, 
and acts best in combination 
with squill and mercury, as 
in the famous Gu} r 's pill. The 
theory of this action, depend- 
ing on heightened blood pres- 
sure within the Malpighian 
tufts, explains the frequent 
failure of digitalis to aug- 
ment the quantity of the 
urine in chronic kidney dis- 
ease, where the arterial ten- 
sion is already high. 



262 



FOXGLOVE. 



V. Uterus — Digitalis, from V. It has, therefore, been 
its action on unstriped mus- used to contract the uterus, 
cular fibre, has the property and thus check flooding or 
of stimulating the uterus to menorrhagia, and it may also 
contraction. act by restoring its normal 

functions when these are sus- 
pended, as in amenorrhcea. 

Cautions, Mode of Administration, etc. 

In prescribing digitalis, we are generally advised to sus- 
pend its use from time to time, lest "accumulation" lead to 
poisonous symptoms ; and experience must have shown us 
that, after its prolonged use, uncomfortable symptoms do 
arise. This may be due to elimination from the kidneys 
being prevented in some measure by the contracting influ- 
ence of the drug on the renal arteries. [See Physiological 
Effects, p. 261.] It is advisable, whilst prescribing the 
drug, to examine the urine from time to time, so as to .sat- 
isfy ourselves that the eliminating functions of the kidneys 
are being properly performed. 

[The well-known variability in the activity of different 
specimens is due in some cases to falsification of the leaves, 
and in other cases to carelessness in gathering them. 
" Good digitalis must be collected when the plant is in full 
flower, selecting only the large lower and root-leaves. The 
midribs of the larger leaves should be removed before using 
them."*] 

As regards the best form for its administration, the freshly 
made infusion is usually preferred. 



$• 


Tinct. digitalis 


nix; 


or 






Sp. £eth. nit. 


f3*s; 


" 


2 




Inf. buchu 


flj; 


(< 


32 


s. 


Ter in die. 









65 Gm. 



M. 



Recommended by Fothergill in 
with scanty flow of urine. 



simple cardiac debility 



I£. Pulv. digitalis gr. xxx ; or 2| Gm. 

Ferri sulph. exsic. gr. xv; " lj " 

Pulv. capsici gr. xl ; " 2j()0 " 

Pil. aloes et my rrlise 5ij« " 8j " M. 

In pil. lx. div. Una bis in die. 



[* Proc. Am. Phar. Assoc. 1881, p. 137.] 



BITTERSWEET — SQUIRTING CUCUMBER. 



2(53 



Recommended by Fotliergill in cardiac debility, gastric 
catarrh, and inactivity of the bowels. 



I£. Tinct. ferri cliloridi tt\,xv 

Glycerinae f 5,j ; 

Infasi digitalis f 3 i j ; 

Syrupi limonis f £ij ; 

Infasi calumbpe q.s.ad f §j ; 
S. Ter die sumend. 

Cardiac tonic. 



Gm. 



M. 



DULCAMARA—BITTERSWEET. 

[ The young branches of Solanum Dulcamara, U. S. 

Officinal Preparations, U. S. 

Deeoetum Dulcamaras (^j to Oj). Dose, f^ss-ij 
(16. to 64. Gm.). 

Extraetum Dulcamaras (alcoholic). Dose, gr. 
x-xx (.65 to 1.30 Gm.). 

Extraetum Dulcamaras Fluidum. Dose, f'3ss— ij 
(2. to 8. Gm.). 

Dulcamara is a feeble narcotic, formerly recommended in 
mania, rheumatism, and cutaneous diseases. At present it 
is never used to any great extent in regular practice.] 



ELATERIUM— SQUIRTING CUCUMBER. 

[A substance deposited by the juice of the fruit of Momordica elaterium, 
Ecbcdium agreste {Richard), U. S. 

Elaterium. Dose, gr. ^ (.015 Gm.). (Dose of Clut- 
terbuck's elaterium, gr. J.) 



Elaterin (not officinal). 
Gm.).] 

Physiological Actions. 

Elaterium produces irrita- 
tion of the intestine, ending 
in inflammation where in- 
cautiously pushed, and causes 
the evacuation of large quan- 
tities of watery fluid. It 
purges equally powerfully 



Dose, gr. ^- T \ (.004 to .005 

Therapeutical Effects. 

Elaterium is the most 
powerful hydragogue cathar- 
tic with which we are ac- 
quainted, and as such has 
been used to withdraw watery 
fluids from the intestines in 
various forms of cardiac dis- 



264 



ERGOT. 



when injected below the skin 
or taken by the mouth, but 
it is stated that solution in 
the bile is necessary to de- 
velop its full action. In 
some of the lower animals, 
peculiar nervous symptoms 
follow its use, and vomiting 
and great depression are li- 
able to be produced in the 
human subject even by mode- 
rate doses. [It is probably 
our most efficient cathartic, 
in the treatment of dropsical 
diseases, especially after the 
failure of other remedies.] 



ease, lightening the labors of 
the heart by lessening the 
volume of the blood, and re- 
lieving the cellular tissue and 
various cavities of dropsical 
accumulations. As, however, 
it is uncertain and very de- 
pressing in its action, it is 
now rarely nsed, in compari- 
son with compound jalap 
powder, which seems to fulfil 
the same useful indications 
without an equal chance of 
seriously weakening the pa- 
tient. 



[Emplastra. 

The officinal Plasters are — 



Emplastrum Aconiti 

' ' Ammoniaci 



; ' cum Hy- 

Antimonii [drargyro 
Arnicse 
Assafcetida? 
Belladonna? 
Ferri 
Galbani Compositum 



Emplastrum Hydrargyri 
Opii 



Picis Burgundicae 
' ' Canadensis 
" cum Cantharide 

Plumbi 

Resinse 

Saponis.] 



ERGOTA— ERGOT. 

[ The sclerotium of Claviceps purpurea (Tulasne), replacing the grain of 
Secale cereale, U. S. 

Officinal Preparations, U. S. 

Extractum Ergotae Fluidum. Dose, Tri,x-f3j (.05 
to 4. Gm.). 

Vinum Ergotae (fgij fid. ext. in Oj). Dose, f3ss-ij 
(2. to 8. Gm.). 

(Ergotilie — not officinal, is a purified extract. Dose, 
gr. v-x=.30 to .65 Gm.)] 



ERGOT. 



265 



External Action. 
Ergot lias no local action. 



Internal Actions. 



Physiological. 

1. On Nervous System. — 
No special action on any part 
of the nervous system has 
been proved. [Beyond the 
condition of comparative an- 
aemia of the nerve-centres 
caused by contraction of the 
vessels.] 



2. On Vascular System. — 
Ergot slightly depresses the 
action of the heart, and re- 
duces the number of its pul- 
sations, and it is said that the 
arterial tension is at first low- 
ered in some slight degree. 
This effect, however, rapidly 
passes away, and a decided 
rise in arterial tension follows 
the contracting influence of 
the drug on the arterioles. 
On examining the web of an 
ergotized frog's foot, we may 
distinctly observe the gradual 
contraction of the smaller 
vessels up to absolute obliter- 
ation of their calibre ; and 
this is believed to be due to 
a primary action of the ergot 
on their muscular walls rather 
than to the intervention of 
23 



Therapeutical. 

1. Dr. Brown-Sequard ad- 
vises the use of ergot in some 
forms of paraplegia, unat- 
tended by irritation, and 
where inflammatory symp- 
toms have subsided, believing 
that it acts well by contract- 
ing the dilated vessels. Dr. 
Crichton Browne has recently 
prescribed ergot with success 
in some forms of chronic 
mania. [It has been used 
in whooping-cough, with as- 
serted good results.] 

2. Ergot is now allowed to 
be by far the best astringent 
in cases of internal hemor- 
rhage, and more especially 
in menorrhagia, haemoptysis, 
and epistaxis, the use of the 
liquid extract having quite 
superseded the older treat- 
ment by means of acids, gal- 
lic acid and the like, whilst, 
if a more rapid action is re- 
quired, we may subcuta- 
neously inject ergotine. [It 
has also been injected into 
internal haemorrhoids with 
success.] 

It is also a valuable remedy 
in purpura. Von Langen- 
beck, of Berlin, has advo- 
cated the injection of ergotine 
for the obliteration of aneur- 
ismal sacs, but sufficient evi- 



266 



ERGOT. 



the vasomotor system. Thus 
we observe a, direct contrast 
to the action of the nitrite of 
amyl. 



3. Respiration and Tem- 
perature No special action. 

4, Urinary Functions 

Ergot, from its specific action 
on unstriped muscular fibre, 
tends to contract the bladder, 
and, by raising the tension 
in the Malpighian bodies of 
the kidneys, it increases the 
urinary flow. 



5. Digestive Organs 

Ergot occasionally causes 
sickness, vomiting, and diar- 
rhoea; but constipation is 
more likely to follow its use, 
from its contracting influence 
on the intestinal capillaries. 



dence has not yet been brought 
forward of the success of this 
practice ; and it has also been 
advised in the case of old 
varicose veins. The gan- 
grenous form of ergotismus 
is doubtless due to arterial 
contraction cutting off the 
supplies of blood to the ex- 
tremities. [Probably it is 
through this influence upon 
the circulation that it is use- 
ful in diabetes insipidus, as 
first suggested by Dr. Da 
Costa, who also uses it with 
good results in albuminuria, 
and also in the excessive 
sweating of phthisis.] 



4. Ergot has been used 
successfully, and more espe- 
cially when combined with 
iron, in that most trouble- 
some affection, incontinence 
of urine ; but, in my own 
experience, belladonna is 
more deserving of confidence. 
Ergot has been recommended 
as a diuretic. Langenbeck 
has much faith in subcuta- 
neous injection of ergotine in 
the atony of the bladder and 
enlarged prostate, met with 
in the old. 

5. Ergot has been success- 
fully prescribed in cases of 
diarrhoea and dysentery. 



ERGOT. 



207 



6. Uterine Functions. — 
Ergot has a remarkable and 
almost selective influence on 
the uterus, contracting its 
muscular walls, promoting 
its functions, and encourag- 
ing the expulsion of its con- 
tents. 



G. Ergot acts as an ecbolic, 
expelling the contents of the 
uterus by causing contraction 
of its muscular walls. It 
must only be used, however, 
where no disproportion exists 
between the child and the 
maternal passages, and where 
we are prepared to render 
instrumental aid at once, if 
necessary, when the pains 
have been aroused. We must 
also remember that its pro- 
longed use is apt to endanger 
the life of the child by cut- 
ting off its supplies of blood 
through the placenta. 

Ergot is also of service in 
flooding, in reducing the size 
of hypertrophied or subin- 
voluted wounds, and in pro- 
moting the destruction of 
submucous polypi, either by 
cutting off their supply of 
blood, or by squeezing them 
out of the uterine cavity. It 
is also an excellent remedy 
for amenorrhea and some 
forms of leucorrhcea. 



Mode of Administration, Dangers, Cautions. 

In those countries where ergotized rye largely prevails, 
two forms of disease attend its use. 1. The gangrenous 
form of ergotismus, where extensive dry gangrene of the 
nose, face, and extremities supervenes ; and, 2. The spas- 
modic variety, where the victim is afflicted with most violent 
and agonizing spasms. [There is room for the suspicion 
that in those places where ergotism occurs, the general 
hygienic conditions are often more at fault than the ergot 
itself.] The therapeutic use of ergot, however, is of course 
never productive of any such symptoms, and the only incon- 



268 ERGOT. 

venience occasionally observed is some digestive derange- 
ment with colicky abdominal pain. 

In addition to those named, the three following prepara- 
tions are officinal in the British Pharmacopoeia : — 

Extractum ergotre liquidum. Dose, tt^x ad f3j (-60 to 
4. Gm.). This is apt to be uncertain. 

Infusum ergotre [Br.]. Dose, f^j adf^ij (32. to 64. Gm.). 

Tinctura ergotaj [Br.]. Dose, tt^x adt5j (-60 to 4. Gm.). 

The powder is also used in doses of from 20 to 30 grs., 
and many experienced authorities recommend a fresh infu- 
sion made with the powder and swallowed. 

Ergotine may be employed by subcutaneous injection, but 
this process has the drawback of causing a painful, black, 
and unsightly lump at the seat, of puncture. 

[Jaccoud (Moniteur de la Policlinique, No. 3, 1882) recom- 
mends for phthsical haemoptysis, hypodermatic injection of 
ergo tin. 

I£. Ergotin. 1 Gm. 

Grlycerinae 

Aquae dest. aa 4i 

Aq. laurocerasi 2| M. 

Of which 20-30 minims are to be injected from two to four 
times a day. 

Prof. DaCosta considers ergotin as the most efficient and 
lasting means of treating the night sweats ot phthisis. (Gr. 
ij three or four times a day.)]. 

I£. Extract! ergotae fluidi f 5U ; or 8|Gin. 

Decocti aloes compositi [Br.] ad f^viij ; " 25ti| " M. 
Fiat mistura, de qua capiat unci am unam bis in die. 

Useful in amenorrhea. 

$. Pulveris ergotae 3j ; or 4 Gm. 

Sacchari 5* v 5 " 16 " 

Aquae bullientis f ,|iij ; " 9(J " M. 

S. Capiat coclilearia duo magna quarta quaque parte horae 
ad effectum. 

In a case of labor. [In America, the wine of ergot or 
the fresh fluid extract in doses of 5j-i y are used in the second 
stage of labor.]. 

In a case of amenorrhea from anaemia we may add a 
little ergot to any chalybeate mixture. 



THOROUGHWORT. 2G9 



[ERIGERON— FLEABANE. 

The leaves and tops of Erigeron lietcrophijllum and of Erigeron 
PhiladelpMcum, U. S. 



ERIGERON CANADENSE—CANADA 
FLEABANE. 

The leaves and tops of Erigeron Canadense, U. S. 

Officinal Preparations, U. S. 

Extraetum Erigerontis Canadensis Fluidum. 
Dose, f'5ss-j (2. to 4. Gm.). 

Oleum Erigerontis Canadensis. Dose, gtt. v 
(.30 Gm.). 

Is diuretic, tonic, and astringent. It is chiefly used in 
hemorrhage in the form of the oil (dropped on sugar) gtt. 
v-xx, repeated every two or three hours ; or a tincture may 
be employed. An infusion has also been used in dropsy, 
and in genito -urinary affections.'] 



[EUPATORIUM— THOROUGHWORT. 

The tops and leaves of Eupatorium per foliation gathered after flowering 
has commenced, U. S. 

Officinal Preparation, U. S. 
Infusum Eupatorii. Dose, f Jj-ij (32. to 64. Gm.). 

Thoroughwort, or Boneset, is a bitter tonic and sudorific, 
and in large doses produces vomiting and purging. The hot 
infusion has been largely given for "colds," muscular rheuma- 
tism, and catarrh. The infusion is emetic in doses of a pint. 
Dose of the powder as a tonic, in dyspepsia, gr. xx-xxx 
(1.30 to 2. Gm.).] 

23* 



270 



YEAST. 



[Extraeta. 



The officinal Extracts are- 



Extractum Aconiti 
" Arnica? 



Extractuin 



Belladonna? 

" Alcoholicum 
" Radicis Fluid um 
Bucliu Fluidum 
Calumba? Fluidum 
Cannabis Americana? 

" Indica? 
Chimaphilse Fluidum 
Cimicifugae Fluidum 
Cinchona? 

" Fluidum 
Colcliici Aceticum 

" Radicis Fluidum 
" Seminis Fluidum 
Colocynthidis 

" Compositum 

Conii 

" Alcoholicum 
" Fructus Fluidum 
Cornus Florida? Fluidum 
Cubeba? Fluidum 
Digitalis 

" Fluidum 
Dulcamara? 

' ' Fluidum 

Ergota? Fluidum 
Erigerontis Canadensis 

[Fluidum 
Gelsemii Fluidum 
Gentiana? 

" Fluidum 
Geranii Fluidum 
Glycyrrhiza? 

" Fluidum 

Gossypii Radicis Fluidum 
Ha?matoxyli 
Hellebori 

Hydrastis Fluidum 
Hyoscyami 



Hyoscyami Alcoholicum 

" Fluidum 

Ignatia? 

Ipecacuanha? Fluidum 
Jalapse 
Juglandis 
Kraineria? 

" Fluidum 

Lupulina? Fluidum 
Matico Fluidum 
Mezerei Fluidum 
Nueis Vomica? 
Opii 

Pareira? Fluidum 
Physostigmatis 
Podopbylli 

Pruni Virginiana? Fluid. 
Quassia? 
Rhei 

" Fluidum 
Rubi Fluidum 
Sabinae Fluidum 
Sarsaparillse Fluidum 

" Compositum Fid. 
Scilla? Fluidum 
Senega? 

" Fluidum 
Senna? Fluidum 
Serpentaria? Fluidum 
Spigelia? Fluidum 

" et Senna? Fluid. 
Stillingia? Fluidum 
Stramonii Foliorum 

' ' Seminis 

Taraxaci 

" Fluidum 
Uva? TTrsi Fluidum 
Valerina? 

" Fluidum 
Veratri Viridis Fluidum 
Zingiberis Fluidum.] 



[FERMENTUM— YEAST. 

A peculiar insoluble product of the fermentation of malt liquors, U. S. 

Yeast is tonic, stimulating, slightly nourishing, and laxa- 
tive. It contains alcohol, gluten, carbonic acid, and bitter 



IRON. 271 

extractive from hops, and has been given, in doses of a pint, 
daily in low fevers attended with irritable stomach. It has 
also been used in diabetes and boils. Mixed with flaxseed 
meal or other farinaceous substances, it forms the yeast poul- 
tice, which is much used in gangrenous ulcers.~\ 



FERRUM— IRON. 

[Ferri Hypophosphis. Hypophosphite of iron. 
Dose, or. v-x (.30 to .60 Gm.). 

Ferri Sulphuretum. Protosulphuret of iron pre- 
pared by melting togtther sublimed sulphur andiron in small 
pieces, U. S. (Used only to make Ilydrosulphuric acid.) 

Officinal Preparations, U. S. 

Ferri Chloridum. Dose, gr. v-x (.30 to .05 Gm.;. 

Liquor Ferri Chloridi. Dose, n^x (.65 Gm.). 

Tinetura Ferri Chloridi. Dose, n^x-xl (.Go to 
2.60 Gm.). 

Ferri Citras. Dose, gr. v-xx (.30 to 1.30 Gm.). 

Liquor Ferri Citratis. Dose, r^x-xl (.65 to 2.60 
Gm.). 

Ferri et Ammonii Citras. Dose, gr. v-x (.30 to 
.65 Gm.). 

Ferri et Ammonii Sulphas. Dose, gr. iij-xij (.20 
to .75 Gm.). 

Ferri et Ammonii Tartras. Dose, gr. x-xxx (.65 
to 2. Gm.). 

Ferri et Potassii Tartras. Dose, gr. x-xxx (.65 to 
2. Gm.). 

Ferri et Quini© Citras. Dose, gr. v-xv (.30 to 1. 
Gm.). 

Ferri et Strychnia^ Citras. Dose, gr. iij-v (.20 to 
.30 Gm.). 

Ferri Ferroeyanidum (Prussian blue). Dose, gr. 
v (.30 Gm.). 

Ferri Laetas. Dose, gr. ij-x (.12 to .Go Gm.). 

Ferri Oxalas. Dose, gr. ij-v (.12 to .30 Gm.). 

Ferri Oxidum Hydratum. Dose, gr. v. (.30 Gm.). 
(As an antidote, gr. xx for each grain of arsenious acid 
swallowed.) 

Ferri Phosphas. Dose, gr. v-x (.30 to .65 Gm.). 



272 



TRON. 



Ferri Pyrophosphas. Dose, gr. ij-vj (.12 to .40 
Gm.). 

Ferri Subcarbonas. Dose, gr. v-xx (.30 to 1.30 
Gm.). 

Emplastrum Ferri. 

Trochisei Ferri Subearbonatis. (Each gr. v. of 
subcarbonate of iron.) 

Ferri Sulphas. Dose, gr. i-v (.0G to .30 Gm.). 

Mistura Ferri Composita. Dose, f^ss (16. Gm.) 

Ferri Sulphas Exsiecata. Dose, gr. i-ij (.06 to 
.12 Gm.). 

Ferrum Redaetum. Dose, gr. ij-v (.12 to .30 Gm.). 

Pilula Ferri Carbonatis (Vallet's Mass). Dose, gr. 
x-xx (.65 to 1.30 Gm.). 

Pilula^ Ferri Composite. Dose, 2 to 6 pills. 

Pilula? Ferri Iodidi (each contains gr. j iodide of iron, 
and gr. i of reduced iron). 

Syrupus Ferri Iodidi (gr. vij J to f 5j)- Dose, tt^xx 
-xl (1.30 to 2.60 Gm.). 

Liquor Ferri Nitratis. Dose, r^x-xx (.65 to 1.30 
Gm.). 

Liquor Ferri Subsulphatis (Monsel's Solution). 
Dose, ^ij-x (.12 to .Go Gm.). 

Liquor Ferri Tersulphatis (used to prepare hy- 
drated sesquioxide of iron). 

Potassii Ferroeyanidum. Dose, gr. x-xv (.65 to 
1. Gm.). 

Iron is also used in preparing Potassii Bromidum, Am- 
monii Bromidum, and Ferri Bromidum (not officinal). 
Dose, gr. x-xx.] 

Local Effects. 



Physiological. 

Certain of the stronger 
preparations of iron are very 
astringent, corrugating and 
hardening the tissues by co- 
agulating their albumen, and 
also contracting the smaller 
bloodvessels. 



Therapeutical. 

In the form of the per- 
chloride [chloride], iron is 
one of our most generally 
used astringents for the ar- 
rest of hemorrhage, as in 
epistaxis, leech-bites, in 
flooding (injected into the 
uterus, as advised by Dr. 
Barnes), or, in fact, in any 



IRON. 



variety passive hemor- 

rhage. 

It is also a valuable appli- 
cation to relaxed mucous 
membranes ; thus, in many 
forms of sore throat, equal 
parts of tinct, ferri and gly- 
cerine will act well. It forms 
a good injection for lencor- 
rhcea, and is extensively em- 
ployed as an enema for the 
destruction of thread-icorms. 
Velpeau recommended the 
application of a strong so- 
lution of sulphate of iron to 
the inflamed skin in erysipe- 
las, and Ricord considers 
that tartrate of iron has an 
almost specific influence over 
the destructive ulcerative 
process of syphilitic phage- 
dena. 



Internal Actions and Uses. 



Physiological. 

1. Brain and Xervous 
System Iron has a tonic in- 
fluence over the nervous sys- 
tem, but occasionally, in ple- 
thoric persons, the stronger 
preparations will cause an 
uncomfortable sensation of 
fulness and throbbing in the 
head. 

[In combination with bro- 
mine, as bromide of iron, it 
is a valuable antispasmodic 
tonic, and is used by Dr. Da 
Costa in chorea.] 



Therapeutical. 

1. Iron is much used as 
a tonic in all conditions of 
nervous exhaustion and de- 
bility. Thus in neuralgia, 
which consists in a weakened 
state of the roots of certain 
sensory nerves, it is invalu- 
able. In chorea, which gene- 
rally coincides with debility, 
and in all cases depending in 
any way on want of nerve 
tone, it is a remedy of real 
value. As originally pointed 
out by Brown-Sequard and 
confirmed by Hughlings Jack- 
son, iron does not agree with 
epileptics, increasing the ten- 



274 



IRON. 



2. Circulation and Respi- 
ration. — Iron acts as a tonic 
to the muscular structures of 
the heart, probably by sup- 
plying the stimulus of a 
larger supply of healthy 
blood. It is well known that 
iron not only augments the 
quantity of red coloring mat- 
ter in the red corpuscles of 
the blood, but actually in- 
creases their number, this fact 
being proved by an ingeni- 
ous instrument which enables 
us to calculate the propor- 
tion of red corpuscles which 
any given specimen of blood 
contains. [Hemacytometer.] 

Iron is held to increase the 
plasticity of the blood and to 
increase the red corpuscles by 
passing into and stimulating 
the lymphatic system and en- 
couraging the transformation 
of the lymph globules. Re- 
cent researches have shown 
that no effect of this nature 
is produced on healthy blood, 
but that in anaemia the num- 
ber of red corpuscles is very 
rapidly increased under the 
use of iron as the primary 
effect, without a proportionate 



dency to fits. Gowers, who 
has carefully investigated this 
point, shows that it makes 
many cases worse, has no in- 
fluence on others, but that a 
third class, on the border line 
between epilepsy and hyste- 
ria, may even derive benefit 
from the action of iron as a 
nervine tonic. 

2. This increase in the red 
corpuscles of the blood, and, 
as a consequence, in the ex- 
tent to which these important 
bodies carry out their func- 
tion of bearing oxygen to the 
tissues, and finally converting 
it into ozone, explains further 
the marvellous tonic influence 
of iron. In ancemia, in pro- 
tracted convalescence from 
acute disease, in general 
feebleness or debility, in chlo- 
rosis where it also acts by 
giving increased tone to the 
uterine functions, in struma, 
rickets, secondary syphilis, 
etc., iron forms the basis of 
every method of treatment. 



IRON. 



275 



rise in the haemaglobin ; how- 
ever, when this also is second- 
arily augmented, the number 
of globules may even fall. 

3, On Secreting Organs. 
— On the stomach, iron acts 
by bracing up the mucous 
membrane, and improving 
the appetite and digestive 
tone. 

Its astringency tends to 
cause constipation. 



8. Here we have another 
explanation of its tonic pro- 
perties. 



Urine Iron increases the 

amount of urea given off by 
the urine, and occasionally 
irritates the bladder, causing 
frequency of micturition. 



This action is utilized in 
the treatment of diarrhoea, 
where some of the more as- 
tringent preparations, as the 
pernitrate [nitrate, U. S.], 
are often of service. 

[But in ordinary tonic 
doses, the tincture of the 
chloride relieves vesical irri- 
tability, strangury, and spas- 
modic stricture; and is much 
used in gleet and chronic 
Brighfs disease.'] 

4. On Temperature Iron 

raises the temperature partly 
by increasing the waste of 
the tissues, but partly also 
in virtue of its ozonizing pro- 
perties. 

Specific Action. 

Iron has a very marked influence in checking erysipelas, 
which must be called specific. TVe here use the tincture of 
the perchloride [chloride], and give it in doses of from i%ss 
to f5j every three or four hours. It is also of service in 
diphtheria; and Dr. Russell Eeynolds has lately brought the 
evidence of over sixty cases to show that in acute rheuma- 
tism, given in large doses, it rapidly diminishes the pain 
and fever. 



Mode of Absorption and Elimination. 

The more soluble forms of iron are readily absorbed, and 
become combined as albuminates with the albumen of the 



276 iron. 

blood, whilst the solid preparations must first undergo 
solution in the gastric juice. When they have played their 
part within the organism, they are thrown out principally 
by the feces, to which they impart a blackish color, but also 
in some measure by the pigment of the urine, the skin, hair, 
nails, urine, and by albuminous secretions, such as those of 
the bile, by all mucous and serous membranes, and by the 
epithelium, etc. etc. 

Modes of Administration. Drawbacks. 

We have seen that various inconveniences may attend 
the use of iron, such as headache, irritability of bladder, 
constipation, nausea, etc., and it further has the disadvan- 
tage of blackening the tongue and teeth; but many of these 
evils may be avoided by using the lighter or less astringent 
preparations, such as the citrate of quinine and iron, wine, or 
saccharated carbonate ; or by combining with some aperient, 
and by giving each dose after a meal. The dyspepsia and 
hepatic congestion occasionally following the use of the more 
astringent of the ferruginous tonics may best be obviated 
by adding one grain of the chloride of ammonium to each 
minim of the tincture of the perchloride. 

But if no contraindication exists, there is no doubt that 
the astringent properties of the per-salts of iron stand us in 
good stead, and, in particular, no preparation is so useful 
on the whole as the old muriated tincture. In secondary 
syphilis the syrup of the iodide is of service, and children 
will always take steel wine or the saccharated carbonate 
well ; whilst in cases of chlorosis with disordered menstrual 
function we shall find the mist, ferri composita to be very 
efficacious in improving the quality of the blood and gently 
stimulating the uterus to resume its neglected duties. The 
sulphate of iron has some influence in aiding the action of 
some purgative salts, as the sulphate of magnesia. The 
preparations of iron are so very numerous that no one but 
a student on the very brink of an examination would think 
of burdening his memory with them all ; and we shall only 
refer, therefore, to those which form part of the daily stock- 
in-trade of the practical physician. 

Vinum ferri [Br.] may be given in doses of from fjj to 
fjij ; mistura ferri aromatica [Br.] f,fj ad f^ij ; mistura 
ferri composita f^j adf^ij ; ferri carbonas saccharata [Br.] 



FIG — MALE FERN. 



277 



gr. v ad 3j ; syrupus ferri iodidi i\x ad f 3j ; ferri et am- 
monia? citras gr. v ad x; ferri et quinise citrus gr. v ad xx. 
Or in combination — 



Tincturae ferri chloridi tt\x ; 


or 




Spiritus chloroformi it[xv; 


" 


1 


Glycerinae f3 ss > 


a 


2 


Infusi calumna? q. 8. ad f 3 j 


a 


32 


Ter die sumend. 







R. 



Chalybeate mixture. 

R. Mistnrae ferri compositae, 

Decocti aloes compositi [Br.] 
Fiat haustus ter die sumendns. 



[65 G 



fm. 



f^ss 



or 16. Gm. 



M. 



M. 



5U; 


or 64 Gm. 


gr. xxiv 


160 " 


f.^ij ; 


" 8: 


q. s. ad f = viij ; 


" 256; 



R. Magnesii sulphatis 

Ferri sulphatis 

Acidi sulphurici diluti 

Infusi calumbre 
S. Capiat coelilearia duo magna onmi mane. 

Ferruginous aperient. 

Iron, as a rule, is best taken after a meal, but we must 
warn our patient to avoid the neighborhood of tea, as the 
mixture of these two ingredients forms a species of ink, which 
is both nauseous and unsightly. As the more astringent 
preparations not only stain but injure the teeth, they may 
be conveniently sucked through a glass tube. 



Figs 
U. S.] 



FICUS— FIG. 
[ The driedfruit of Ficus Carica, U. S. 
are slightly laxative, and enter into Confectio Senna?, 



FILIX MAS— MALE FERN. 



[The rhizome covered with portions of the stipes of Aspidium Filix mas. 
When used only such portion of the rhizome as has retained its green 

color should be employed, and the stipes, being inert, should be re- 
moved, u. s. 

Officinal Preparation, U. S. 

Oleoresina Filieis. Dose, t^v-xv (.30 to 1. Gm.).] 

Local Action. 

Fern oil has no local action. 
21 



278 



FENNEL. 



Constitutional Action. 



Physiological. 

The only marked action of 
the male fern is that of killing 
tape-worms. It occasionally 
produces a little nausea and 
diarrhoea, but in most cases 
it can be taken without dis- 
comfort. [Its virtue resides 
in an oleoresin, which is the 
officinal title in the U. S. P., 
but which is termed a fluid 
extract in the Ph. Br. ; it is 
also sometimes spoken of 
simply as the oil of male 
fern.] 



Therapeutical. 

Fern-oil is used in medi- 
cine purely as an anthelmin- 
tic. Its destructive influence 
over all varieties of tcenice 
has been effectually proved 
by a great mass of evidence, 
and one or two doses gene- 
rally succeed in dislodging 
the entire worm. It is essen- 
tial that the draught should 
be taken on an empty sto- 
mach, and, the intestines 
having been first cleared by 
a purgative, we direct our 
patient to fast for a few hours 
before bed-time, when he is 
advised to take a drachm of 
the liquid extract [oleoresin] 
suspended in milk. Or we 
may avail ourselves of the 
following formula, which acts 
well in concealing the nause- 
ous flavor of the dru£ : — 



B 



f5jss; 



Oleoresinre filicis 
Mucilaginis tragacanthse f §ss 
Syrupi zingiberis f.^li 

Aqure q. s. ad f ,|iss ; " 48 

Misce, fiat haustus nocte vel primo inane suniendus. 



[FGENICULUM— FENNEL. 

The fruit of Fceniculum dulce (De Candolle) U. S. 

Officinal Preparations, U. S. 

Oleum Fceniculi. Dose n^v-xv (.30 to 1. Gm.). 
Aqua Foenieuli (oil tti^xv to Oj). 

Also enters into Tinctura Rhei et Senna3. 
Much used in infusion as an aromatic carminative, for 
flatulent colic in infants.] 



GALBANUM — NUTGALL. 279 

GALBANUM— GALBANUM. 

[ The gum-resin of an undetermined plant, U. S. 
Dose, in substance, gr. x-xx (.65 to 1.30 Gra.). 

Officinal Preparations. 

Emplastrum G-albani Compositum (containing 
also turpentine, Burgundy pitch, and lead plaster). 

Pilula^ Galbani Composite (each, galbanum, gr. 
jss ; myrrh, gr. jss; assafoetida, gr. ss).] 

Also enters into Emplastrum Assafbetidre. 

Galbanum and ammoniacum are substances of no special 
theoretical value [but are ranked as expectorants, anti- 
spasmodics, and stimulants]. 



GALLA—NUTGALL. 

[A morbid excrescence upon Quercus infecteria, U. S. 

Officinal Preparations, U. S. 

Acidum Gallicum. Dose, gr. v-xx (.30 to 1.30 Gm.). 
Glyceritum Aeidi Gallici (3ij to 3j). 
Tinctura Gallae (gij to Oj). Dose, i'3j-f3iij (4. to 
12. Gm.). 

Unguentum Gallae (1 to 7 of lard). 
Acidum Tannicum. Dose, gr. j-iv (.00 to .25 Gm.). 
Unguentum Aeidi Tanniei (5ss to §j.). 
Glyceritum Aeidi Tanniei (Jij to f'^j). 
Suppositoria Aeidi Tanniei, each gr. v. 
Troehisei Aeidi Tanniei, each gr. j.] 

External Action. 

Physiological. Therapeutical. 

Tannic acid has a powerful Tannic acid is a better 
local astringent action, owing topical astringent than gal- 
partly, no doubt, to its power lie, and may be used to arrest 
of coagulating albumen, and hemorrhage, or diarrhoea, or 
"tanning," in some degree, as an injection for gonorrhoea 
any part to which it may be and leucorrhcea. Combined 
applied. with glycerine, in the form 

of the glycerite of tannin, it 
is very useful as an appli- 



280 



NUTGALL. 



Internal 
Tannic and gallic acids are 

both powerful astringents, 
but as tannic acid is rapidly 
converted in the system into 
gallic acid, it is preferable to 
use the latter. This convic- 
tion is proved by the fact that 
if we take the urine of a pa- 
tient to whom tannic acid has 
been given, we find that it 
will not precipitate gelatine, 
but that it strikes a blackish 
tint with the persalts of iron. 



cation in various forms of 
sore throat, and to arrest the 
discharge in some chronic 
affections of the os uteri, in 
the chronic-weeping stage of 
eczema, in ozcena, and chronic 
otorrhcea. It may also soothe 
and restrain some of those 
irritable coughs which de- 
pend on chronic irritation 
about the pharynx. Galls 
are used, in the form of oint- 
ment, as an application to 
haemorrhoids. 

Action. 

Tannic acid is rarely used 
internally, but gallic acid is 
serviceable in various forms 
of hemorrhage, such as hce- 
moptysis, lice mateme sis, and 
Menorrhagia ; but in all of 
these it must yield the palm 
to ergot, and it is more espe- 
cially in hemorrhage from 
the kidney that its curative 
action comes into play. It 
has also been used with suc- 
cess to check the excretion 
of albumen in chronic renal 
disease. 



R. Acidi gallici 


5.1 ; 


Cllycerinfe 


fgss; 


Aquse destillata? 


f3 v J ; 


S. f 3J ter die. 





4| Gin. 
16 " 
192 " 



M. 



For hemorrhages. 

[As tannin in the usual form of solution or in substance 
is only slowly absorbed by the mucous membrane of the in- 
testinal tract, Dr. LeAvin 1 recommends its administration in 
solution in the form of an albuminate, which tastes better and 
is more easily absorbed, thus he uses : — 



Deutsdi Med. Wocli. No. 6, 1881. 



GAMBOGE. 281 

R. Sol. acidi tannici, 2. gr. in 100. 

Misce, agitando, et adde — 

Sol. album, ovi unius 10.0. 
M. 

The quantity of the albumen must, if necessary, be in- 
creased so as to correspond with the tannic acid. 

For long-continued administration, the following is bet- 
ter :— 

I£. Acid, tannic! gr. ij-5. 

Aquse destillatse 100. 

Misce et adde — 

Album, ovi unius. 

Solutio sodii bicarb, q. s. tit ft. solutio limpida. 
M. D. S. 

Or, simply : — 

$. Acidi tannici 1. to 5. 

Aqu?e 150. 

Solutio sodii bicarb, q. s. ad react, alkalin. 
M. D. S. 

Which should be kept well corked and not used until it 
has stood 24-48 hours.] 



GAMBOGIA— GAMBOGE. 

[A gum resin derived from Gar'cinia Morella (Desrousseaux) var. 
pedicellata, U. S. 

Dose, in substance, gr. ij-iij (.12 to .20 Gm.). 

It enters into Pilule Cathartics Composite.] 

Local Action. 

Gamboge has no local action, and differs from some other 
remedies of the same class in not exerting its purgative 
effects when applied to a raw surface or injected into the 
cellular tissue. 

Constitutional Action. 

Physiological. Therapeutical. 

On the Digestive and Se- Gamboge is a drastic, hy- 

creting Organs Gamboge dragogue cathartic, formerly 

exerts a good deal of irri- much used where free purga- 
tating effect, acting more tion of watery fluid seemed 

24* 



282 



GAMBOGE. 



especially on the small intes- 
tine, and producing the dis- 
charge of large quantities of 
watery fluid. If given in 
sufficient quantity, inflam- 
mation and ulceration of the 
stomach and intestines may 
supervene, and death has 
followed the administration 
of a single drachm of the 
powder. It is also usually 
looked upon as a diuretic, 
but no trustworthy evidence 
has been given of its efficacy 
in this direction. 



to be indicated, as in cardiac 
dropsy; but it is not only 
disagreeable and irritating, 
but uncertain, and has there- 
fore been in great measure 
superseded by other remedies 
on which more dependence 
can be placed. 



Absorption, Mode of Elimination, etc. 

In order to insure its full absorption it seems necessary 
that gamboge must be previously dissolved in the bile, as we 
have seen that local application does not produce any purga- 
tive effect. It is, of course, thrown out in great measure by 
the intestines, but the coloring matter is excreted by the 
urine, to which it imparts a bright yellow tinge. 

Mode of Administration, Dose, etc. 

The great objection to the use of gamboge is its uncer- 
taint} r , as we can never precisely foresee the cases in which 
it will cause troublesome vomiting and purging. To try and 
obviate this, therefore, as well as to conceal its acrid taste, 
we generally combine it with other drugs ; but on the whole 
I think I am justified in saying that gamboge has no thera- 
peutic advantage which cannot be obtained more conveniently, 
and agreeably by the use of other purgative drugs. 

We may most conveniently prescribe the compound pill 
which contains gamboge, aloes, cinnamon, hard soap, and 
syrup, and of which the dose is from 5 to 15 grains. [The 
compound cathartic pill U. S. P. contains calomel gr. j ; jalap 
gr. j ; compound extract of colocynth gr. j J ; and gamboge 
gr. ^. Dose, 1 to 4 pills.] ■ 



YELLOW JASMINE. 283 

rGAULTHERIA— PARTRIDGE-BERRY. 

The leaves of Gauliheria procumbens, IT. S. 
Officinal Preparations, U. S. 
Oleum Gaultheriae. Used for flavoring. 

Used in Syrupns Sarsaparillae Coinpositus, and Trochisci 
Morphiae et Ipecacuanhas. 

Winter-green, or tea-berry, is an aromatic astringent 
tonic, but is chiefly used as a flavoring addition to mixtures.] 



GELSEMIUM— YELLOW JASMINE. 

[The root of Gelsemium semper vi reus (Grafs Manual of Botany) , U. S. 

Officinal Preparation, U. S. 

Extraetum Gelsemii Fluidum. Dose, gtt. r^v-x 
(.30 to .05 Gin.). 

An alkaloid gelsemia, discovered by Wormley, exists in 
the root ; in combination with gelsiminic acid. 

The tincture is generally kept in the shops, but is not offi- 
cinal. Dose, gtt. x-xl (.60 to 2.60 Gm.) A saturated 
tincture is also made, of which smaller doses are to be 
given.] 

Constitutional Action. 

Physiological. Therapeutical. 

1. Brain and Nervous 1. Gelsemium has been 

System Large doses of gel- prescribed with - success in 

semium cause vertigo and neuralgia of the fifth nerve, 
double vision. [Cerebral ef- intercostal and ovarian neu- 
fects are explained by the ac- ralgia, and myalgia. 
cumulation of carbonic acid Dr. Spencer Thompson has 
in the blood, secondary to healed 40 cases of neuralgia 
respiratory paralysis. (Bar- successfully by gelsemium, 
tholow.)] A paralyzing in- pointing out, however, that 
fluence is exerted on the its beneficial action is con- 
spinal cord, the power of fined to affections of the tri- 
voluntary movement being facial nerve, and more espe- 
linally quite abolished, numb- cially to the branches supply - 
ness and staggering being ing the upper and lower jaw, 
preliminary symptoms. Re- and particularly the latter, 



284 



YELLOW JASMINE. 



flex irritability is also sus- 
pended, the pupil dilates, and 
at a later stage the sensory 
columns of the cord are also 
paralyzed, producing com- 
plete anaesthesia (Bartholow). 
The first nerve affected is 
the 6th at its termination, 
causing paralysis of the ex- 
ternal rectus, and later on the 
3d is also attacked. A curi- 
ous point about its action is, 
that when taken internally it 
contracts the pupil, whereas 
on topical application, rapid 
and full dilatation is produced, 
being complete in from 50 to 
70 minutes. One advantage 
which it undoubtedly has 
over atropia, in addition to 
the swiftness of its effects, is, 
that the resulting diminution 
of accommodation for near 
objects is never so well 
marked, and passes away par- 
tially in 10 or 15, and abso- 
lutely in 30 hours. 

Ringer tells us that large 
doses of the alkaloid [Gel- 
semia, of which gr. -*- has 
caused death], at first para- 
lyze, and then excite tetanus, 
which in a short time gives 
way to paralysis. 

2. Heart and Circulation. 
— A slightly weakening effect 
on the heart is noted. [This 
is explained by Ott on the 
view that it diminishes the 
pulse-rate by lessening the 
irritability of the excito- motor 
ganglia of the heart, and the 
arterial pressure by diminish- 



and that the dose must be full 
ir L xx of the tincture, repeat- 
ed, if necessary, in lj hour. 

[In other disorders of the 
cutaneous nerves, as in pru- 
rigo, gelsemium has been 
successfully applied in dilute 
solution; and.it has recently 
been recommended also for 
rhus poisoning. 

$. Acid, carbol. f gss ; or 2 Grn. 
Ext.gelsem.fld.f3ij; "8 
Glycerin re, f^ss ; or 16 
Aquae, f§ij ' "64 

M. Sig. For local application. 

(Dr. Edson, Medical Re- 
cord, July 29, 1882.)] 

This would indicate a cer- 
tain advantage in ophthal- 
moscopic examinations over 
atropia, which causes much 
annoyance to hard-worked 
people by impairing vision 
for a week or ten days after 
use. 



It has been recommended 
as a remedy for tetanus. 



GENTIAN. 



285 



ing cardiac irritability and 
vaso-motor tonus, but Bar- 
tholow states that the action 
of the heart persists after 
stoppage of respiration.] 

3. Respiration and Tem- 
perature The respirations 

become labored, shallow, 
and irregular, from dia- 
phragmatic paralysis, death 
ensuing from asphyxia. The 
temperature falls, probably 
in consequence of the pro- 
fuse perspiration which it 
induces. 

4. Digestive Organs. 
[Nausea and vomiting result 

from large doses, lasting sev- 
eral hours, this effect being 
produced by both its local 
and cerebral effect.] 

Dose, etc. 

"We may give the tincture every three hours, until droop- 
ing of the eyelid, dilatation of the pupil, and muscular lan- 
guor are noted. [As it is certain that an idiosyncrasy exists 
in regard to this drug with certain patients, it is only safe to 
begin with two or three drop doses, as serious results have been 
reported by Dr. Wharton Sinkler and others from its use. 
In the treatment of poisoning by gelsemium hypodermic in- 
jections of morphia and atropia, and the use of ammonia, 
and diffusible stimulants are necessary, with hot applications 
and friction to the extremities.] 



3. Bartholow recommends 
gelsemium in various forms 
of convulsive or spasmodic 
cough, and in acute inflam- 
mations of the lungs and 
pleura he thinks it may do 
good by diminishing the ac- 
tivity of the respiratory func- 
tions. 

4. The remedy should not 
be too frequently repeated, 
for fear of cumulative effect. 



GENTIANA—GENTIAN. 

[The root of Qentiana lutea, U. S. 

Officinal Preparations, U. S. 

Extraetum Gentianse. Dose, gr. ij-iv (.12 to .25 
Gm.). 



286 CRANESBILL — GLYCERINE. 

Extraetum Gentian® Fluidum. Dose, m x-xxx 
(.65 to 2. Gm.). 

Infusum Gentianae Compositum. Dose, fsj-ij 
(32. to 64. Gm.). 

Tinetura Gentian® Composita. Dose, f 5j-iv (4. 
to 16. Gm.). 

Gentian is the type of the simple bitters, and is largely 
employed in cases where a tonic of this kind is indicated. 
As it contains no astringent element, it may readily be ex- 
hibited in combination with iron. 

Gentian and chiretta may be grouped together, as their 
action is almost precisely similar. They are both light, 
agreeable tonics, with pleasant, aromatic, bitter flavor, and 
may be used freely in dyspepsia and debility with loss of 
appetite. Gentian has always, however, been much more 
generally employed than chiretta, and this may be partly 
due to the very agreeable compound preparations of the 
former drus. 



[GERANIUM— CRANESBILL. 

The rhizome of Geranium maculatum, U. S. 
Officinal Preparation, U. S. 

Extraetum Geranii Fluidum. Dose, f 5ss— j (2. 
to 4. Gm.). 

Crowfoot, or cranesbill, is an indigenous astringent tonic, 
containing tannic and gallic acids, and may be used with 
advantage in bowel complaints, and as a styptic. A decoc- 
tion in milk is sometimes given to children.] 



GLYCERINA—GLYCERINE. 

\_A colorless, inodorous, syrupy liquid, of a siceet taste, and having the 
sp. grav. 1.25, U. S. 

Used in preparing officinal Extracta Fluida, and the 
Glycerita.] 

This useful substance is almost exclusively used externally. 
It moistens and softens the skin, and when properly diluted 
both prevents and cures the painful and unsightly cracks 
known as "chaps" on the hands. It is a serviceable appli- 
cation, either alone or combined with other drugs, in various 
forms of skin disease. 



GLYCERINE. 287 

It may soothe an irritable cough by moistening the dry- 
ness of the throat, and it is stated to be the most efficient 
means at our command for the prevention of bedsores. In 
addition to this, it forms an excellent vehicle for the solution 
of various drugs, as seen in the five glycerites of the Phar- 
macopoeia, having this additional advantage, that its adhe- 
sive nature enables the active ingredient to remain longer 
than it otherwise would in contact with the affected surface. 
It is also a good solvent of the alkaloids, dissolving them 
freely, and, being decidedly antiseptic, it is now used for 
the preservation of vaccine lymph. 

Internal Use. 

It was thought at one time that glycerine might prove an 
agreeable and efficient substitute for cod-liver oil ; but this 
has not been confirmed, and glycerine is now seldom used 
internally. It has, however, some gentle laxative proper- 
ties, and has lately been very confidently recommended as a 
remedy for bleeding piles. M. Catillon, working in Vul- 
pian's laboratory, has found by experiment on animals that 
it increases the appetite, promotes nutrition, and lessens the 
urea. It would therefore seem worthy of further trial as an 
analeptic, although, if the observations of MM. Dujardin 
Beaumetz and Audige are correct, it is a drug of active 
physiological properties not to be rashly employed. These 
gentlemen found that, by subcutaneous injection, it causes 
tetanic rigidity, like strychnia, elevation of temperature, 
hematuria, and meningeal congestion. [It has been highly 
commended as a substitute for sugar in the diet of diabetic 
patients.] 



[Glyeerita. 

The officinal Glycerites are — 

Glyceritum Acidi Carbolici Glyceritum Picis Liquids? 

" Acidi G-allici " Sodii Boratis. 

" Acidi Taunici 

Their uniform strength is 5ij to the ounce, except glycerite 
of tar, which is 5*s to f'oj-] 



288 BARK OF COTTON ROOT. 

GLYCYRRHIZA— LICORICE. 

[The root of Glycyrrhiza glabra, U. S. 

Enters into the manufacture of Decoctum Sarsaparillna 
Compositum, Extractum Glycyrrhizae, Extractum Sarsa- 
parillse Fluidum Compositum, Infusum Lini Compositum, 
Pilula3 Hydrargyri, and Syrupus Sarsaparillre Compositus. 

Officinal Preparations, U. S. 

Extractum Glycyrrhizae Fluidum (for flavoring). 

Extractum Glycyrrhizae. Liquorice. 

Mistura Glycyrrhizae Composita. Brown mix- 
ture. Dose, fgss-j (16. to 32. Gm.). 

Troehisci Glycyrrhizae et Opii.] 

This is only used as a flavoring ingredient [and enters 
into the Piluke Ferri Iodidi, Tinctura Aloes, Tinctura Rhei 
et Sennas, and Troehisci Cubelxe. 

Liquorice is an excellent demulcent, and in the form of 
decoction is used in catarrhal affections and diarrhoea. It 
is largely used as a flavoring ingredient, and is perhaps the 
best adjuvant to quinia, to disguise the bitter taste of that 
drug. The compound licorice mixture (Brown mixture) 
contains paregoric (fsij), antimonial wine (f^j), and sweet 
spirits of nitre (f'o ss ) in each pint (U. S.). It is very com- 
monly used in bronchitis, acute and chronic, in combination 
with ammonium chloride, and stimulating expectorants like 
syrup of senega, or tincture of ipecacuanha.] 



[GOSSYPII RADICIS CORTEX—BARK OF 
COTTON ROOT. 

The bark of Gossi/pium herbaceum, and of other species of 
Gossypium, U. S. 

Officinal Preparation, U. S. 

Extractum Gossypii Radieis Fluidum. Dose, 
f5ss-j (2. to 4. Gm.). 

This is an efficient oxytocic and emmenagogue, largely 
employed in the South, in the form of decoction (f^iv to 
Oj) as a parturifacient. A tincture is also used.] 



GUAIAC. 289 

GOSSYPIUM— COTTON. 

[A filamentous substance separated from the seed of Gossypium 
herbaceum, and of other species of Gossypium, U. S. 

Officinal Preparations, U. S. 

Pyroxylon. Gun Cotton. 

Collodium. Pyroxylon dissolved in ether and alcohol.] 

This useful substance is employed in various inflammatory 
conditions, with the view of excluding air and supplying 
warmth and slight support. Thus in burns, and more es- 
pecially in those of a superficial nature, the immediate appli- 
cation of a thick layer of cotton-wool relieves the smarting 
pain and promotes recovery ; and the same treatment may 
be recommended to a blister after the watery fluid has been 
removed from the bulla. In acute rheumatism, also, the 
patient may derive much relief from the careful and equable 
encircling of his inflamed joints with cotton-wool, secured in 
position by a few turns of flannel bandage. 

It is also believed by some aurists to form the best mate- 
rial for the construction of an artificial membrana tympani. 

[Cotton-root bark as a parturifacient has considerable repu- 
tation throughout the South ; it is used in recent decoction 
or as a fluid extract. It does not appear to have aborti- 
facient powers (Martin, Am. Journ. Med. Sciences, Prize 
Essay), although a valuable oxytocic in tedious labor. 

For Collodion, see page 242.] 



[GUAIACUM— GUAIAC. 

Guaiaei Lignum. The heart-wood of Guaiacum 
officinale, U. S. 

Guaiaei Resina, A 'peculiar resin obtained from 
Guaiacum officinale, by spontaneous exudation, by incision, 
by dry heat, or by decoction of the comminuted wood, U. S. 

Officinal Preparations, U. S. 
Tinctura Guaiaei. Dose, f5j-ij (4. to 8. Gm.). 
Tinetura Guaiaei Ammoniata. Dose, f'5j-ij (4. 
to 8. Gm.). 

Also enters into Decoctum Sarsaparillae Compositum, 
Syrupus Sarsaparilke Compositus, and Piluke Antimonii 
Composite. 
25 



290 GUTTA-PERCHA — LOGWOOD. 



Uses. 

Guaiac is alterative, and is largely employed in chronic 
rheumatism, rheumatoid arthritis, and syphilis. The am- 
moniated tincture is the best preparation, and is usually given 
in milk.] 

GUTTA-PERCHA— GUTTA-PERCHA. 

[The concrete juice of Isonandra gutta (Hooker. Loudon' s Journal of 
Botany, 1848), U. S. 

Officinal Preparation, U. S. 

Liquor Gutta- Per ehae (in chloroform). Used in 
making chart a sinapis.] 

Gutta-percha is only adapted for external use, and is of 
service mechanically as a material for splints, being readily 
softened in hot water and moulded to the affected joint or 
limb. It furnishes a cheap and efficient rival to oiled silk, 
and its solution in chloroform forms a good and impervious 
covering in smallpox, erysipelas, and other affections where it 
is of importance to protect the skin from the action of the air. 



ILEMATOXYLON— LOGWOOD. 

[The heart-wood of Hcematoxylon Campechianum, U. S. 

Officinal Preparations, U. S. 

Deeoctum Haematoxyli. Dose, fgij (64. 6m.). 
Extraetum Haematoxyli. Dose, gr. x (.65 Gm.).] 

Physiological Action. Therapeutical Use. 

Logwood has astringent It is an agreeable and 
properties. efficient remedy in diarrhoea, 

and is well taken by chil- 
dren. We must remember 
that it imparts its pink color 
to the feces, and to the urine 
should that secretion chance 
to be alkaline. 

[It may be combined for diarrhoea as in the following 
formulae : — ] 

]£. Extracti haematoxyli gr. x ; or 165 Gin. 

Tincturse catechu 15^s ; " 2| " 

Syrupi fjjj ; " 4i 

Aquae carui q. s. adffj; " 16| " M. 
S. Ter die sumeudus. 



AMERICAN PENNYROYAL — BARLEY. 201 

B. Pulveris cretse aromatici (Br.) 3.1; or 4l(Tm. 

Tincturse opii l'3i ; " 4: " 

Syrupi zingiberis fgj ; " 32 > " 

Decocti hsematoxyli q.s. adf^vj; " 192| " M. 

Fiat mistura, cujas suiuat imciam unam post singulas dejec- 
tion es liquidas. 



[HEDEOMA— -AMERICAN PENNYROYAL. 

The leaves and tops of Hedeoma Palegioides, U. S. 
Officinal Preparation. 
Oleum Hedeomae. Dose, gtt. ij-x (.12 to .65 Gm.). 
Hedeoma is a gentle stimulant aromatic used in flatulent 
colic, sick stomach, and in amenorrlioza. In recent suppres- 
sion of the menses, it is a popular domestic remedy, given in 
warm infusion.] 



[HELLEBORUS— BLACK HELLEBORE. 

Root of Helleborus niger, U. S. 

Dose of the powdered root, gr. ij-iij, as an alterative; or 
gr. x-xx as a purge (.12 to 1.30 Gm.). 

Officinal Preparations, U. S. 

Extractum Hallebori. Dose, as a purgative, gr. x 
(.65 Gm.). 

Tinetura Hellebori. Dose, as a purgative, f5ij 
(8. Gm.). 

Chiefly interesting on account of its popularity among the 
ancients as a hydragogue cathartic, but as it is harsh and 
uncertain in its action, it is rarely, if ever, used at present, 
except as an ingredient in emmenagogue pills.] 



HORDEUM— BARLEY. 

[ The decorticated seed of Hordeum distichon, 17. S. 
Officinal Preparation, U. S. 
Deeoctum Hordei (5J to Oj) may be used ad !ib.~\ 
In the form of decoction, barley is used as a demulcent 
drink. [Malt extract is largely used as nourishment, given 
preferably in milk. Malt wine, and malt liquors are of spe- 
cial value in convalescence from the specific fevers, as they 
are tonic, moderately stimulating, and promote constructive 
metamorphosis.] 



292 HOPS — MERCURY. 

HUMULUS— HOPS. 

[The strobiles of Humulus lupulus, U. S. 

Lupulina. The yellow powder separated from the stro- 
biles of Hamulus lupulus, U. S. 

Officinal Preparations, U. S. 

Infusum Humuli (^ss to Oj). Dose, ad lib. 

Tinetura Humuli (sijssto Oj). Dose, f§ss-ij (16. 
to 64. Grii.). 

Extractum Lupulinse Fluidum (^xvj to Oj). 
Dose, t"5ss-ij (2. to 8. Gm.). 

Oleoresina Lupulinae. Dose, 7TLx-f"3j (-Q5 to 4. 
Gm.). 

Tinetura Lupulinae (3 ij to Oj). Dose, fgss-ij (16. 
to 64. Gm.).] 

Hops are tonic and probably narcotic, more especially in 
the form of the old-fashioned hop-pillow. Internally they 
are rarely prescribed. [They may be used as an anodyne 
cataplasm, either alone or with Indian meal. The prepara- 
tions of lupulin are some.times administered in delirium 
tremens as a sedative tonic] 



HYDRARGYRUM—MERCURY. 

[^4 silver-white metal, liquid at common temperatures, and having the sp. 
grav. 13.5 U. S. 

Officinal Preparations, U. S. 

I. In the Metallic State. 

Hydrargyrum. 

Emplastrum Ammoniaci cum Hydrargyro. 

Emplastrum Hydrargyri. 

Hydrargyrum cum Creta (mercury 37-^ per cent.). 

Dose, gr. v-xxx. (.30 to 2. Gm.). 
Pilulse Hydrargyri (mercury 33^ per cent.), 3 gr. pills. 
Unguentum Hydrargyri (mercury 50 per cent.). 

II. Oxidized. 

Hydrargyri Oxidum Rubrum. Used externally. 

Unguentum Hydrarg. Oxidi Rubri (3j-3 v lD- 
Hydrargyri Oxidum Flavum. Used externally. 

Unguentum Hydrarg. Oxidi Flavi (5j-5 v U)' 



MERCURY. 293 

III. Sulphuretted. 

Hydrargyri Sulphuretum Rubrum. (For Fumigating.) 

IV. As Protoehloride (subchloride?). 
Hydrargyri Chloridum Mite. Dose, gr. ss-x (.03 to 

.65 Gm.). 

Pilulse Antimonii Composite (calomel lGf per cent.). 

Pilulre Cathartics Composite (each pill contains, calo- 
mel, ext. jalap, aa gr. j ; ext. colocynth. comp. gr. 
jj; and gamboge, gr. J). Dose, 1 to 4. 

V. As Bichloride (proto-chloride ?, perehloride, 

Br.). 
Hydrargyri Chloridum Corrosivum, gr. y^-iV («004 

to .000 Gm.). 
Hydrargyrum Ammoniatum. Used externally. 
Unguentum Hydrarg. Ammoniati (gr. xl-^j). 

VI. With Iodine. 

Hydrargyri Iodidum Rubrum (biniodide), gr. J^ (.004 
Gm.). 

Unguentum Hydrargyri Iodidi Rubri (gr. xvj to^j). 
Liquor Arsenici et Hydrargyri Iodidi (Donovan's 

Solution). Dose tt^v-x (.30 to .65 Gm.). 
Hydrargyri Iodidum Viride (protiodide). Dose, gr. J 

(.015 Gm.). 

VII. With Cyanogen. 

Hydrargyri Cyanidum. Dose, gr. j 1 ^— Af (.005 Gm.) 

VIII. With Acids. 

Liquor Hydrargyri Nitratis. As a caustic. 

UnguentumHydrargyri Nitratis (Citrine ointment). 
Hydrargyri Sulphas Flava. Dose, gr. \— \ (Turpeth 

Mineral). As an emetic, gr. ij (.015 to .12 Gm.). 

Poisoning. 

In the metallic state, mercury exercises but slight influence, 
but in a state of vapor it is capable of causing violent symp- 
toms. All the salts of mercury are poisonous ; but the most 
important is corrosive sublimate. 

The symptoms caused by corrosive sublimate resemble 
those produced by arsenic, but, from the salt being more 
soluble, they are inore immediate and violent; there is a 
more marked taste, the evacuations are more frequently 

25* 



294 MERCURY. 

bloody, and there is a whitened condition of the epithelium 
of the mouth. There are three varieties of poisoning with 
mercury. In the first, the leading symptoms are, violent 
irritation of the alimentary tube ; namely, vomiting, purging, 
pain at the pit of the stomach, and irritation in the throat; 
metallic, sty pic taste, corrosion of the mouth, tongue, and 
palate ; constriction of the throat, and difficulty of swallow- 
ing. Blood evacuated both by vomiting and by stools, sup- 
pression of urine, countenance flushed, tumid, and bloated. 
In the second variety, salivation and sloughing of the mouth 
succeed to the irritation and inflammation. In the third, 
mercurial erethism comes on, and is not preceded by the 
symptoms of local irritation. The first variety arises from 
the more soluble salts of mercury, in large doses; the second, 
from the same preparations, but in smaller doses and more 
diluted ; the third, by the more insoluble and refractory 
compounds. 

Morbid Appearances. — These are similar to those at- 
tendant on irritative or corrosive poisoning. There are, 
frequently, shrivelling of the tongue, and enlargement of its 
papillae and root. In some cases, red and black spots in the 
interior of the heart. Corrosion, ulceration, and disorgani- 
zation of the mucous coat of the stomach and intestines. An 
inflamed condition of the urinary organs is also frequently 
observed. 

Tests. 

Corrosive sublimate in a solid state is sublimed when 
heated in a test-tube ; and the acrimonious fumes speedily 
condense into a crystalline, semi-transparent mass. Placed 
in a test-tube, and lime-water, potassa, or soda, added in 
solution, a yellow (peroxide of mercury) precipitate, is thrown 
down. 

In solution, ammonia throws down a white (ammonio- 
chhride of mercury) precipitate. Solution of proto-chloride 
of tin affords a precipitate (calomel), which, at first, is white, 
but acquires a leaden color on adding more of the test; when 
this precipitate (after being well agitated) is dried, minute 
globules of quicksilver may be detected. Transmission of 
sulphuretted hydrogen produces a (sulphuret of mercury) 
precipitate, which at first is leaden colored, then black. 
Solution of iodide of potassium affords an intensely brilliant 
scarlet (biniodide of mercury) precipitate, which dissolves in 



MERCURY. 290 

an excess of the test. Corrosive sublimate may be reduced 
to the metallic state through galvanic influence, applied as 
follows : A drop of the suspected fluid being laid on a piece 
of polished gold, and both it and the gold touched at the 
same instant by a point of iron (as a thick needle, or the 
end of a penknife), a small silvery coating of mercury soon 
becomes apparent on the gold. Being freely soluble in sul- 
phuric ether, addition of this fluid is of much service when 
the poison is found mingled with organic or other matters. 

The cyanide, when heated in a tube, evolves cyanogen 
gas, which will burn with a rose-red flame, with a blue halo. 

Calomel is sublimed by heat. When treated with potassa, 
or lime-water, it assumes a black appearance, mercurous 
oxide being separated. 

On cautious application of heat, the biniode sublimes in 
red-colored crystals, which soon change to yellow, and sub- 
sequently to a dusky hue. On exposure to a sufficient degree 
of heat, iodine fumes are disengaged. When mixed with 
potassa (equal weights) and heated in a test-tube, decompo- 
sition occurs; metallic mercury being sublimed, and iodide of 
potassium deposited in the tube. 

When red precipitate is exposed to heat in a test tube, 
metallic mercury is sublimed, with the evolution of oxygen. 

If the persulphate be treated in the same manner as the 
foregoing, sublimation of the mercury takes place, and sul- 
phurous acid gas is evolved. (Griffith's Formulary.) 

Antidotes. 

Acute poisoning produced by corrosive sublimate requires 
albumen (white of eggs, blood, or flour and water) and de- 
mulcents. Milk maybe freely drunk, and vomiting encour- 
aged. Gold-leaf and iron-filings form a chemical antidote, 
decomposing the chloride and depositing the mercury. It 
has been stated that the hydrated proto-sulphuret of iron, if 
taken immediately, completely destroys the poisonous pro- 
perties of the corrosive sublimate.] 

Local Actions. 
Physiological. Therapeutical. 

One preparation, the acid The acid nitrate is used as 

nitrate, is a very powerful an application in lupoid ul- 



296 



MERCURY. 



caustic, in virtue of its free 
nitric acid. 

Other preparations are oc- 
casionally used externally for 
skin diseases, syphilitic ulcer- 
ations, etc., and in virtue of 
the destructive power which 
they all (but more especially 
corrosive sublimate) exert 
over the lowest forms of ani- 
mal and vegetable life. Mer- 
cury, being readily absorbed 
by the skin, is frequently in- 
troduced into the system by 
this channel. 

[When using the acid ni- 
trate of mercury as a caustic 
to chancroids or other sores, 
care should be taken to have 
it diluted with from ten to 
twelve parts of water. When 
applied stronger it sometimes 
causes very troublesome he- 
morrhage.] 



cerations, and in ulcerations 
about the os and cervix uteri. 

Calomel in lime-water 
[3j to Oj] forms the familiar 
black-wash which is of great 
service in venereal ulcera- 
tions, either primary or secon- 
dary ; and the same salt, in 
the form of powder, may be 
dusted on condylomata or 
corneal ulcerations with ad- 
vantage. Corrosive subli- 
mate, in the form of lotion, 
often checks troublesome ul- 
cerations of the throat ; and 
both this and the various 
forms of mercurial ointment 
are almost infallible reme- 
dies for pediculi or i'orfavus, 
tinea tonsurans, and other 
skin diseases which are known 
to depend on the presence of 
minute vegetable growths. 
We must remember, how- 
ever, that dangerous symp- 
toms, and even death, have 
occasionally been caused by 
the absorption of the mineral 
when thus applied. 

Many chronic skin dis- 
eases may be well treated 
by citrine ointment. Goitre 
frequently yields Jn India to 
the inunction of the binio- 
dide, and Mr. Marshall has 
highly recommended the 
oleate of mercury as an ap- 
plication to various joint af- 
fections. 

The external application 
of mercury, by the calomel 
vapor bath, or blue ointment, 
having for its object the pro- 



MERCURY". 



297 



d u c t i o n of constitutional 
effects, will be considered 
further on. 



Internal Actions and Uses. 



1. Brain and Nervous Sys- 
tem — Mercury, pushed up to 
the development of poisonous 
symptoms, produces a curious 
condition of nervous debility 
and tremors, which is occa- 
sionally met with in work- 
men who have been freely 
exposed to its fumes in silver- 
ing glass. 

2. Circulation and Respi- 
ration — One form of mer- 
cury, the perchloride, or cor- 
rosive sublimate, acts as a 
cardiac poison, distinctly low- 
ering the action of the heart, 
but the other preparations 
have no such influence. Mer- 
cury causes anaemia by de- 
stroying the red corpuscles of 
the blood. It has long been 
observed that they become 
spheroidal and of deeper hue, 
have less cohesion, and finally 
dissolve. The blood becomes 
more fluid, and the fibrine 
less coagulable. [But in mi- 
nute doses, gr. T * ^ to T ^, 
given thrice daily for a length 
of time, corrosive sublimate 
acts as a tonic and increases 
the number of the red- blood 
corpuscles, particularly in sy- 
pltilitic ancemia.] 

3. Secreting Organs — Sto- 
mach and Intestines Mer- 
curial preparations, and more 
especially calomel, act as 



1 . Mercury has been found 
of most signal service in some 
forms of advanced syphilitic 
disease affecting the brain. 



2. Mercury acts well in 
some forms of bronchitis by 
removing congestive oedema 
of the mucous membrane, 
and promoting the absorption 
of exudations and deposits. 



3. In that form of vomiting 
common in children, where 
the stomach rejects every- 
thing suddenly and violently, 



298 



MERCURY. 



purgatives, causing repeated 
grayish or greenish evacua- 
tions; the duodenum being 
the portion of the gut pri- 
marily acted upon. The ac- 
tion of mercury on the liver 
has provoked a good deal of 
controversy ; and, whereas it 
was formerly held that the 
biliary secretion was directly 
stimulated, the experiments 
of Bennett and the Edinburgh 
Committee seem to show that, 
on the contrary, the flow of 
bile is actually checked or 
diminished by calomel. Two 
obvious fallacies underlie 
these experiments — the first 
being that the dogs, kept for 
considerable periods with bili- 
ary fistula, were so affected 
not only by the shock of the 
operation, but by the result- 
ing inconvenience, general 
discomfort, and gradual starv- 
ation, that secretion must of 
necessity have been in great 
measure suspended ; and, sec- 
ondly, it is well known that 
a remedy which has no effect 
on a healthy organ may pow- 
erfully modify its condition 
when in a state of congestion 
or functional derangement. 



\ gr. of hyd. cum creta or \ 
gr. of calomel every hour will 
often cure, as Ringer has 
shown. Small doses of the 
perchloride are also useful in 
dysenteric diarrhoea. 

Calomel and blue pill are 
frequently used as adjuncts to 
other purgative drugs. 

Clinical evidence has most 
distinctly proved, not only 
that the well-known symp- 
toms of biliousness may be 
most effectively removed by 
the old-fashioned blue pill 
and black draught, but that 
an increase of bile may also 
be thus produced in the mo- 
tions. This has been ex- 
plained by the irritating in- 
fluence of the mercury on the 
duodenum, and the conse- 
quent sweeping away of the 
secreted bile, which, under 
ordinary circumstances, is 
well known to undergo reab- 
sorptionfrom the intestines. 

Mercury has been supposed 
also to act by stimulating the 
gall-bladder to contract. 

But the careful experi- 
ments of Rutherford have 
proved that whilst calomel 
stimulates the intestinal 
glands, but not the liver, cor- 
rosive sublimate is a power- 
ful hepatic, but a feeble in- 
testinal stimulant. 

There is no foundation for 
the belief that calomel acts 
by being converted into cor- 
rosive sublimate through the 
action of the gastric juice. 



MERCURY. 



299 



Kidneys Mercury, a n d 

more especially blue pill, has 
the power of promoting the 
action of diuretics. 

Saliva Mercury is well 

known to stimulate the action 
of the salivary glands, large 
quantities of their secretion 
being poured out when the 
drug is pushed far enough. 
The fluid, at first thick and 
containing much albumen, 
subsequently becomes thin 
and watery. 

Skin Inunction of ting. 

hydrargyri is apt to bring out 
a crop of irritable pimples, 
and one of the symptoms of 
mercurial poisoning is an ec- 
zematous eruption. 

Mercury is supposed to 
stimulate absorption by ren- 
dering effused fibrine less co- 
hesive, by promoting its dis- 
integration, and by retarding 
cell-orowth. 



Thus, in the form of Guy's 
pill, containing blue pill, 
squill, and digitalis, we ob- 
tain a most marked diuretic 
effect. 

The old-fashioned notion is 
now happily exploded, that 
we must measure efficacy 
of our mercurial treatment by 
the amount of salivation. 



Ringer praises an ointment 
of calomel 5j> to spermaceti 
5J, in pruritus and pityriasis 
of the scalp, and mercurial 
ointments generally are ex- 
cellent stimulants in many 
chronic skin affections. 

Mercury was accordingly 
invariably given, in former 
days, in all cases where any 
effusion of fibrine was sup- 
posed to have taken place, 
such as the second stage of 
pneumonia. 



Specific Action. 

Mercury may be said to act as a specific, or at least as a 
true vital antidote, in syphilis, and more especially in the 
primary and secondary stages of that insidious malady. 
When we are satisfied that we have to deal with an infect- 
ing sore, the sooner we begin our mercurial treatment the 
better; and it is well to push it in small doses for a considera- 
able time, until the gums are slightly affected. For tin's pur- 
pose moderate doses of blue pill and opium are perhaps the 
most effectual ; but we may also derive much benefit now 
and then from rubbing in 5 SS to 3j of blue ointment, night 
and morning. The whole train, also, of secondary eruptions 



300 MERCURY. 

of the skin, sore throat, condylomata, iritis, etc., must also 
be subjected to mercurial treatment, and the calomel vapor 
bath and the bichloride of mercury will here do us good 
service. 

It is doubtful whether, by the most careful and scientific 
treatment of a primary sore, we can altogether prevent the 
development of secondary symptoms ; but if we cannot do 
this we can at least postpone them, and render them less 
severe, and also lessen the probability of tertiary mischief. 
In order to get the most satisfactory results, we must con- 
tinue a careful administration of mercury for many months, 
and if this be done, there seems no doubt that syphilis can 
be readily cured, or finally be eradicated from the system. 

In the congenital syphilis of young children, the local ap- 
plication of a little blue ointment, either rubbed into the skin 
or smeared over a bit of flannel wound round the waist, is 
eminently satisfactory in its results. 

Mercury was formerly believed to have a specific influence 
in checking the inflammations of serous membranes, and was 
consequently invariably used in peritonitis, pericarditis, and 
pleurisy ; but faith in this conviction has been a good deal 
shaken of late, and the conventional calomel and opium does 
not so often appear in prescriptions as formerly. 

On the continent much importance is attached to con- 
siderable doses of calomel in the early stages of typhoid fever, 
but statistics do not seem to prove any decided advantage as 
accruing from this mode of treatment. 

Drawbacks, Cautions, etc. 

It is important to be familiar with the signs which indi- 
cate when the mercurial treatment has been carried far 
enough. The gums generally give the first token in a deli- 
cate red line running along their margin, followed by pulpy 
thickening of the interdental portions, and finally retraction 
from the teeth. To this succeed [a metallic taste in the 
mouth,] an increased flow of saliva and a peculiar fetor of 
breath, and we generally find that the very slightest " touch- 
ing" of the gums is sufficient to show that the physiological 
effect of the mineral has been attained. 

[It should be remembered that salivation comes on rather 
slowly and sometimes appears a day or two after the adminis- 
tration of the mercurial has been suspended ; showing that 



MERCURY. 301 

the system may be fully influenced by the remedy for at 
least twenty-four hours before its specific action on the mouth 
is apparent.] 

Whilst a patient is undergoing a mercurial course, we 
must keep up his constitution well with good diet, iron, and 
perhaps -a little stimulant ; for experience shows that mercury 
far more speedily exerts its debilitating influence on weak 
persons or those who are enfeebled by fasting. 

We must, therefore, beware of its use in consumptive or 
strumous persons, or in those suffering from Bright's disease 
or diabetes, and recollect that idiosyncrasy may here play an 
important part, and that some persons are much more readily 
salivated than others, without known cause. 

Children, more especially those under the age of two years, 
are rarely if ever salivated, and only show the influence of 
the drug by peculiar greenish stools ; but w r e must beware of 
using it in them too freely, as Mr. Hutchinson has traced a 
peculiar malformation of the teeth to the incautious use of 
gray and other so-called "teething" powders in early life. 
[But w r here salivation does occur in children it is apt to be 
uncontrollable, and to be followed by destructive ulceration, 
or gangrene of the mouth and lips, with ugly cicatrices.] 

Mode of Elimination, etc. 

Mercury is eliminated principally by the urine, but also 
in smaller degree by the saliva and the biliary and intestinal 
secretions. 

Modes of Administration, Dose, etc. 

In the treatment of syphilis, mercury may be given by 
inunction, in which from §ss to 3j of blue ointment is rubbed 
into the skin once or twice a day, varying the place of appli- 
cation so as to avoid that cutaneous irritation which may 
otherwise result. This method, although very effectual, is 
dirty, and rather liable to cause excessive salivation. 

The oleate of mercury made by dissolving the oxide in 
oleic acid, and varying according to strength from a clear 
solution to a resin-like ointment, is a very clean way of using 
the drug externally, and, in addition to its value in syphilis, 
may be employed in articular inflammation, simple syno- 
vitis, threatening abscess, orchitis, sycosis, etc. (Marshall.) 
26 



302 MERCURY. 

Fumigation is also extensively employed, but it is only 
of real service in the cutaneous affections dependent on 
secondary syphilis, where the actual deposition of the vapor- 
ized calomel on the skin produces a beneficial local influence. 
Twenty grains of calomel are used at each sitting, and are 
diffused along with watery vapor by a spirit lamp, and 
brought in contact with the patient, as he sits covered with 
a blanket, on a perforated chair, over the fumigating appa- 
ratus. 

Corrosive sublimate has been used by subcutaneous injec- 
tion, but in this way it creates great local irritation, hard, 
black, painful lumps, often running into abscess, being pro- 
duced at the site of puncture, and although much ingenuity 
has been expended on the search for a harmless solution, no 
success has yet attended these efforts. This, however, 
matters the less, because no reliable evidence has been offered 
to show any advantage in this plan over others, and it is un- 
doubtedly much better to administer it by the mouth, when 
it is specially useful in chronic skin and throat affections. 
Some authorities prefer to give it alone, whereas others advise 
a combination with potassium iodide, thus : — 

P^. Hydrarg. chlor. corrosiv. 
Potassii ioclidi 

Decocti cinchona? :< 256| M. 

S. f § j ter die post cibum. 

fy. Hydrarg. chlor. corrosiv 
Acidi muriatici diluti 
Mellis despumati 
Aquae destillatae q. s. adffx; "320 " M. 

An excellent gargle for syphilitic throat ulceration. 

Opinions vary considerably regarding the best form of 
mercury for internal administration in the treatment of sy- 
philis. Mr. Hutchinson prefers hydrarg. cum creta in doses 
of from gr. iij to gr. v. two or three times a day. Kicord, on 
the other hand, advises gr. j-iij of the green iodide [but it is 
ordinarily given in much smaller doses to begin with], whilst 
others are content to employ the pil. hydrarg. in gr. j-iij 
doses in pill, keeping its purgative properties in check- by a 
little opium. 



£r. ss ; 


or 


03 Gm 


5*s 

tgviij ; 


" 2| 
" 25G| 


gr. ij ; 
f5ij ; 
fli; 

±'fx; 


or 

" 8 
" 32 
" 320 


12 Gm 
it 



ty. Pil. hydrargyri gr. ij ; or 

Pulveris opii gr. \ ; 

Confectionis rosae q. s. 

Ut fiat pilula quarta quaque hora sumenda. 



12 Gm. 
015 " 

M. 



MERCURY. 303 

[The following is a good formula for the protiodide: — 

R. Hydrarg. iodidi viridis 

Extract, lactucarii aagr. xlv; or 3|(rm. 

Extraqt. opii gr. xv ; " ]| " 

Confectionis rosae £jss ; " 6| " M. 

In pil. no. lx. dividenda. 

S. Dose, 1 to 3 pills a day.] 

For purgative purposes the blue pill is generally pre- 
scribed in 5-grain doses, taken overnight, and aided by some 
saline aperient in the morning. 

E/. Hydrarg. clilor. mitis gr. xij ; or SO Cxm. 

Mannae gr. vj ; " |40 " 

Pulveris tragacanthae comp. [Br.] gr. vj ; ' ; ,40 " M. 

Divide in pilulas sex. Capiat duas pro re nata. 

A good purgative formula. 

As a diuretic the following is the useful old combination, 
sometimes known as the "-Guy's," and sometimes as 
"Baillie's Pill :"— 



ty.. Pilulae hydrargyri gr. iij ; 

Pulveris scillae gr. jss 

Pulveris digitalis gr. ss ; 

Fiat pilula bis terve die sumenda. 



20 Gm. 

10 " 

03 " M. 



[Unguentum hydrargyri nitratis (citrine ointment) is much 
used as a stimulant and alterative application in chronic 
skin diseases and ophthalmia. It generally requires to be 
diluted with lard. 

The decoction of Zittmann may be used with great ad- 
vantage as a gentle diaphoretic and alterative in secondary 
syphilis, either alone or as an adjuvant to mercurials. It 
has been also used with advantage in scrofulous conditions 
of the system, in chronic rheumatism, in skin diseases, and 
obstinate ulcerative affections. The dose is one wine-glassful 
of each strength several times daily. The formula of the 
Prussian Pharmacopoeia is as follows : — 

Decoctum Zitmanni fortius Take of sarsaparilla root 

cut 100 parts; digest in water 2G0O parts for 24 hours, and 
add, inclosed in a linen bag, powdered sugar and alum, each 
G parts, calomel 4 parts, and cinnabar 1 part ; then heat in a 
covered vessel placed in a steam-bath for three hours, stirring 
frequently, and. near the end of the boiling, add anise and 
fennel, bruised, each 4 parts, senna, cut 12 parts, and licorice- 
root, cut 12 parts. Express, strain, set aside for some time 



304 HYDRASTIS — HENBANE. 

and decant to obtain 2500 parts of clear liquid ; 2500 
grammes of this are to be divided into 8 parts. 

Decoctum Zittmanni mitius Take the residue left from 

the preceding and 10 parts of sarsaparilla ; heat with water 
2G00 parts, for three hours, in a covered vessel placed on a 
steam-bath, stirring frequently, and when near the end of 
the boiling, add lemon-peel, cinnamon, cassia, cardamom, and 
licorice-root, each, cut and bruised, 3 parts. Express and 
operate as before, to obtain 2500 parts. 1 

Mercury was detected by Wiggers in this decoction in 
very small proportion. It should not be prepared in metal- 
lic vessels lest the mercurial in solution should be decom- 
posed.] 

[HYDRASTIS— HYDRASTIS. 

The root of Hydrastis Canadensis, U. S.- 

Officixal Preparation, U. S. 

Extraetum Hydrastis Fluidum. Dose, f5»j-iv 
(8. to 1G. Gin.). 

Hydrastis is an indigenous bitter tonic, containing the al- 
kaloids berberina and hydrastia, and is said to have decided 
diuretic properties. A decoction has been used as an injec- 
tion in gonorrhoea. Its exact therapeutic place among reme- 
dies does not appear to be well defined ;] but it is said to be 
a stomachic tonic, useful in atonic dyspepsia, in chronic al- 
coholism, and in hemorrhoids and some hepatic disorders. 



HYOSCYAMUS— HENBANE. 

[Hyoseyami Folia. The leaves of Hyoscyamus 
niger, U. S. 

Hyoseyami Semen. The seed of Hyoscyamus 
niger, U. S. 

Officinal Preparations, U. S. 

Extraetum Hyoseyami (from the juice). Dose, gr. 
i-iij (.06 to .20 Gm.). 

Extraetum Hyoseyami Aleoholieum (dried 
leaves). Dose, gr. ^ to gr. j (.01 to .06 Gm.). 

1 [The National Dispensatory, Stille and Maiseh, Philadelphia, 
1879, p. 497.] 



HENBANE. 305 

Extraetum Hyoseyami Fluidum (leaves). Dose, 
rtiv (.30 Gm.). 

Tinetura Hyoseyami (dried leaves, ^ij to Oj). Dose, 
f3ss-ij (2. to 8. Gm.). 

Hyoscyamus is, like belladonna, a hypnotic and mydriatic, 
and owns the same antidotes.] 

The remarks made with reference to stramonium are 
equally applicable to hyoscyamus, which also contains an 
alkaloid, hyoscyamia, probably identical with atropia. The 
main point of difference, then, from belladonna, is the supe- 
rior narcotic powers of hyoscyamus, which have been espe- 
cially prized and developed in lunacy practice. It is also a 
favorite remedy in painful and irritable affections of the 
bladder, where it seems to exert a marked soothing influence, 
and it is an excellent addition to cough mixtures. 

I£. Extracti belladonna gr. iij ; or !20 Grin. 

C amphorae gr. xij ; " SO " 

Extracti hyoscyanii gr. xv ; '' 1[ " 

Misce, fiant pilulae sex, quaruin sumat unain hora decu- 
bitus. 



Narcotic for nervous insomnia. 

ty.. Tincturae hyoseyami tt^xxx ; or 2 

Potassii carbonatis gr. x ; " 

Syrupi papaveris [Br.] t'3U ! " 8 

Aqua? camphorse, q. s. adf^iss; " 48 

Misce, fiat haustus hora somni sumendus. 

Narcotic. 



Gm. 

65 " 



R. 


Vini ipecacuanha 


«5iJ ; 


a 


8 




Ext. hyoseyami fluid, 


$j ; 


a 


4 




Tincturae scillae 


f§ss ; 


it 


161 




Syrupi tolutani 


ffi; 


a 


321 




Aquae carui q. s. 


ad fgvj ; 


ti 


1921 



Misce. Capiat semuueium ter quaterve in die. 

Cough Mixture. 

Dr. Robert Lawson, late of the West Riding Asylum, has 
recently made a large variety of very interesting physiologi- 
cal and therapeutical observations on the actions and uses of 
Hyoscyamia, the alkaloid of hyoscyamus. He has found 
that it produces " a subdued form of mania, accompanied by 
almost complete paralysis of the voluntary muscles, and end- 
ing in quiet and refreshing sleep ;'' and he thinks that this 

26* 



806 HENBANE. 

might advantageously be substituted for opium in many forms 
of extreme excitement occurring among the insane. He has 
derived great benefit from the drug in " the treatment of 
recurrent, acute, and subacute mania, and the monomania of 
suspicion," and recommends the following formula : — 



I£. Hyoscyamise 


gr.j; 


or 




06 Gm 


Sp. setheris [Br.] 1 


TT^viij ; 


" 




50 " 


Alcoholis 


ttptxiv ; 


<( 


1 


60 " 


Aquse fontis 


q. s. ad f§j 


a 


32 


(< 


Misce, ut fiat haustus. 











Ringer records a very interesting case of acute mania in 
which gr. j of hyoscyamia quieted the patient and produced 
sleep, the first dose causing deep flushing of the face and 
hands, with quickening of the pulse. He has found it useless 
in delirum tremens. Mr. Clifford Gill, of the York Asy- 
lum, has made many observations on the drug, finding 
that physiologically it causes loquacious rambling, hallucina- 
tion of sight and hearing, drowsiness, hypermetropia, dry- 
ness of mouth, and deficient co-ordination of lower limbs. 
In violent mania it acts well, but as some persons are intole- 
rant of its action, and death has been caused by syncope, we 
must proceed cautiously and begin with small doses (gr. J— 
■§). The pure alkaloid is quite expensive, but an efficacious 
extract containing the amorphous salt is made by Merck ; 
and Gill recommends a solution of gr. ij to the *j of ether and 
alcohol, freshly prepared; as it soon deteriorates, it must be 
kept from the light. It has also been used with some success 
in chorea. 

[According to Gnauck (Centralblatt fur die Med. Wis- 
senschaften, No. 45, 1881) hyoscyamine is composed of hyos- 
cine and tropaic acid. From experiments upon healthy in- 
dividuals and others, he concluded that hyoscine is ten times 
stronger than hyoscyamine. Small doses of the iodide of 
hyoscine produce the same symptoms as hyoscyamine, in ad- 
dition, however, there is a retardation of the pulse even with 
larger doses, varying with the dose and susceptibility of the 
individual. 

Even -g\-Q of a grain invariably produces some of its effects 
in from two to twelve minutes. The fall in the pulse is the 
first symptom to appear and the last to disappear, the re- 
duction ranging from eight to twenty beats. 

1 [A solution of ether, one part, to rectified spirit, two parts.] 



ISINGLASS — IGNATIA. 307 

A slight reduction of the pulse also occurs at the beginning 
of the action of atropine and hyoscyamine, and with small 
doses, but this is quickly followed by paralysis of the ter- 
minal filaments of the vagus. Hyoscine probably causes the 
fall by irritation of their filaments; tropaic acid, therefore, 
having the power to alter its action.] 



[ICHTHYOCOLLA— ISINGLASS. 

The sicimmincj bladder of Acipenser Huso, and of other fishes, U. S. 

Isinglass is only used in medicine as an article of diet for 
the sick, and as the basis of court-plaster. ,] 

[IGNATIA—IGNATIA. 

The seed of Strychnos Ignatia, U. S. 

Officinal Preparations, U. S. 

Extraetum Ignatiae. Dose, gr. \-\ (.015 to .03 
6m.). 

Is used for the same purpose as Nux Vomica, but the 
extract, containing more strychnia, is a somewhat stronger 
preparation.] 



[Infusa. 

The officinal Infusions are — 

Infusum Angustura? Infusum Lini Composituin 

" Anthemidis " Pareira? 

" Buchu " Picis Liquids 

" Caluniba? " Pruni Virgiuianae 

" Capsici " Quassia? 

" Caryophylli " Rhei 

" Cascarillae " Rosa? Compositum 

" Catechu Compositum " Salvia? 

<£ Cinchona? Flava? " Senna? 

" Cinchona? Rubra? " Serpentaria? 

" Digitalis " Spigelia? 

" Eupatorii " Tabaci 

" Gentiana? Compositum " Taraxaci 

" Hamuli " Valerians 

" Juniperi " Zingiberis.] 
" Krameria? 



308 IODINE. 



IODINIUM— IODINE. 

[A bluish-gray non-metallic element obtained principally from the ashes of 
sea-weeds. It melts and rises in purple vapor when heated. 
In bluish-black crystalline scales having the metallic lustre. Its specific 
gravity is 4.9. 17. S. 

Officinal Preparations, U. S. 

Tinetura Iodinii (Iodine |j to Oj). Dose, gr. v-x 
(.30 to .65 Gm.). 

Tinetura Iodinii Composita (Iodine ^ss; potass. 
iod. ^i ; alcohol Oj). Dose, gtt. x-xx (.65 to 1.30 Gm.). 

Liquor Iodinii Compositus (Iodine 5 v j ; potass, 
iod. 5jss ; water Oj). Dose, gr. v-x (.30 to .65 Gm.). 

Unguentum Iodinii (Iodine gr. xx, potass, iod. gr. iv 
to gj). 

Unguentum Iodinii Compositum (Iodine gr. xv, 
pot. iod. gr. xxx, lard 5J). 

Liquor Arseniei et Hydrargyri Iodidi (Dono- 
van's Solution). Dose, gtt. v-x (.30 to .65 Gm.). 

Syrupus Ferri Iodidi (iodide of iron, 7 J gr. to f3j). 
Dose, tt^x-xxx (.65 to 2. Gm.). 

Pilulffi Ferri Iodidi (ferri iodid. gr. j ; ferri redact. 
g r - i)- 

Also enters into Sulphuris Iodidum, Unguentum Sulphuris 
Iodidi, Arseniei Iodidum, Hydrargyri Iodidum Rubrum, 
Unguentum Hydrargyri Iodidi Rubri, Hydrargyri Iodidum 
Viride, Plumbi Iodidum, Potassii Iodidum, and Unguentum 
Potassii Iodidi. 

Antidotes. 

Starch and demulcents. For the inconvenience arising in 
some persons very susceptible to iodine (as the severe catar- 
rhal symptoms after taking potassium iodide), a warm bath 
and small doses of deodorized tincture of opium are useful. 

Incompatibles. 

With Iodine. — Alkalies and alkaloids (quinia and strych- 
nia) ; extracts containing starch ; water precipitates the 
iodine from tinetura iodinii. The compound tincture may 
be diluted with w r ater without precipitation. 



IODINE. 



309 



With Potassii Iodidnm Acids, acetate of lead, and the 

metallic salts generally. 

With Ferri Iodidnm Lime-water, alkalies, and the 

vegetable astringents.] 

Local Actions. 



Physiological. 

Iodine in substance is 
never used save for its anti- 
septic properties. Dissolved 
in spirit, however, it is an 
excellent . counter-irritant, 
producing itching and smart- 
ing of the skin, with desqua- 
mation of cuticle, and even 
blistering if the application 
be too frequently repeated. 
It has been shown that this 
local action of iodine is at- 
tended by a very free extru- 
sion of colorless blood cor- 
puscles into the subcutaneous 
cellular tissue. 

Experiment has proved 
that iodine is not absorbed 
into the system through the 
unbroken cuticle. [But fatal 
poisoning has resulted from 
absorption of a solution of 
iodine, which had been in- 
jected into an ovarian cyst. 

Iodine and the soluble 
iodides are incompatible with 
the alkaloids as well as with 
most metallic salts in solu- 
tion.] 



Therapeutical. 

It is therefore of some 
value for the correction of 
fetor in drains, etc. 

The tincture or liniment 
of iodine is very extensively 
used as a counter-irritant 
application to enlarged 
glands, chronic abscesses, 
swollen joints, chilblains, and 
to various forms of skin 
disease, more especially the 
common varieties of ring- 
worm, which speedily yield 
to this treatment. It is very 
useful when painted over the 
chest in chronic pneumonia 
and fibroid and tubercular 
affections of the lungs; and 
Mr. Jordan, of Birmingham, 
has recently drawn attention 
to the great success attained 
by him in the dispersion of 
boils, carbuncles, and svppu 
rating glands by iodine freely 
applied to a neighboring vas- 
cular area. 

It is also an excellent in- 
jection into various secreting 
cavities, curing hydrocele by 
obliterating the sac of the 
tunica vaginalis, acting well 
on the same principle in some 
rare cases of ovarian dropsy 
and bronchocele, and deo- 
dorizing and lessening dis- 
charges in empyema and 



310 IODOFORM. 

suppurating glands. [In 
scrofula, Lugol's solution may 
be injected directly into the 
enlarged glands, with great 
benefit.] 
[For the Constitutional Effects, see Iodide of Po- 
tassium. 

Hydriodic acid is a recent addition to our means of ad- 
ministering iodine for obtaining the constitutional effects, 
and it has been used with success in asthma, bronchitis, and 
hay fever. It is prepared on a small scale by the action of 
hydrogen sulphide on iodine mixed with water. It is, when 
pure, a colorless, irrespirable, and uninflammable gas, resem- 
bling somewhat in odor hydrochloric acid. Dissolved in 
water, it forms a clear, limpid solution, with an acid reac- 
tion, and rather a pungent, styptic taste ; but quickly de- 
composes upon exposure to the air, the solution becoming 
colored by free iodine. It may be obtained, however, in a 
stable form as a syrup. Gardner's syrup of hydriodic acid 
is of a light-straw color, free from smell, with a sweet, 
styptic, though not disagreeable, taste. Each fluidounce 
contains about forty minims of dilute hydriodic acid, equiva- 
lent to six and a half grains of iodine. The dose usually 
ordered is from one to three drachms in water, several times 
a day.] 



• [IODOFORMUM— IODOFORM. 

In yellow, scab) crystals having the odor of saffron. It is insoluble in 
water, but soluble in alcohol, ether, and the fixed and volatile oils. By 
a heat above 250° it is decomposed, giving off violet vapors. U. S. 

It is prepared by decomposing an alcoholic solution of 
iodide of potassium with lime. As a local anaesthetic, it is 
applied in powder to painful ulcers, whether chronic, can- 
cerous, or syphilitic, where it relieves pain and promotes 
cicatrization. Suppositories (gr. v-x).are used in hemor- 
rhoids and uterine cancer. In ethereal solution (20 per 
cent.), it has been highly recommended as an application in 
chronic inflammation of the throat} Its abominable odor 
almost forbids its use outside of the hospital wards.] 

[Phila. Med. Times, vol. iv. p. 4, 1873.] 



IPECACUANHA. 



311 



IPECACUANHA—IPECACUANHA. 

[ The root of Cephaelis Ipecacuanha, U. S. 
Officinal Preparations, U. S. 

Extractum Ipecacuanhas Fluidum. Dose, gtt. 
xxx (2. Gm.). 

Pulvis Ipecacuanhas Compositus. Dover's pow- 
der (ipecac, gr. j, opium gr. j, sulph. potass, grs. viij.). Dose, 
gr. x (.65 Gm.). 

Troehisei Ipecacuanhas (gr, \ in each). 

Troehisei Morphias et Ipecacuanhas (Morphia 
gr. qL; ipecacuanha gr. T Vj). 

Syrupus Ipecacuanhas (extract f|ij to syrup xxx). 
Do*h, f'Sj-fgss (2. to 16. Gm.). 

Vinum Ipecacuanhas (fjij extract, to sherry wine 
fjxxx). Dose, *5j-iv (4. to 16. Gm.).] 



Local Actions. 



Physiological. 

The prolonged application 
of ipecacuanha to the skin 
causes some irritation, fol- 
lowed by the appearance of 
vesicles, pustules, and even 
troublesome ulceration. In 
some persons the powdered 
root causes violent irritation 
of the respiratory passages, 
ranging from symptoms re- 
sembling hay-fever up to a 
spasmodic condition analo- 
gous to true asthma. 



Therapeutical. 

The use of the slowly act- 
ing and pustulating forms of 
counter -irritation has fallen 
out of fashion, as they are 
not only disfiguring, but give 
less relief than more sedative 
applications. 

The only way in which we 
find ipecacuanha employed 
locally is in the form of 
spray, which Prof. Ringer 
has found very useful in 
chronic bronchitis, winter 
cough, bronchial asthma, 
with emphysema and fibroid 
phthisis. As the pure wine 
may cause nausea and irrita- 
tion, he advises a dilution 
with from 1 to 2 parts of 
water, using the ordinary 
spray - producer, beginning 



;i2 



IPECACUANHA. 



with about twenty squeezes 
for the first sitting, once a 
day, but afterwards more fre- 
quently repeated, the mouth 
being well rinsed out after 
each application. Cases of 
winter cough were generally 
cured in twelve days. 



Constitutional Actions. 



1. Brain and Nervous 
System — 1. No effect seems 
to be produced on the brain. 

2. Ipecacuanha has a mark- 
edly stimulating influence on 
that centre in the medulla 
oblongata which presides 
over the action of vomiting. 
Whether by subcutaneous 
injection, or by being taken 
into the stomach, it causes, 
within a moderate period, a 
decided but mild emetic ef- 
fect ; and as this may arise 
either from irritation of the 
mucous membrane of the sto- 
mach, or from a primary stim- 
ulation of the vomiting centre 
itself, ipecacuanha must be 
ranked among both the di- 
rect and the indirect emetics. 

Emetia given by subcu- 
taneous injection is much 
slower in its action, and re- 
quires to be given in larger 
closes than by the mouth, 
which proves that it must 
primarily act on the mucous 
membrane of the stomach. 

It may be said generally to 
occupy a middle place be- 
tween sulphate of zinc and 



2. Ipecacuanha cannot be 
recommended in cases of 
poisoning, for not only does 
it act too slowly, but its nau- 
seating and depressing influ- 
ence may be injurious. It 
is of great service, however, 
in many of those affections 
of the throat or respiratory 
organs where we wish to 
empty the lungs or detach 
foreign bodies or false mem- 
branes from the larynx or 
trachea, as in bronchitis, 
croup, diphtheria, etc. 

A most remarkable fact in 
the action of this drug is its 
power, when given in small 
doses, of checking vomiting. 
Thus, in the vomiting of 
nursing, pregnancy, or men- 
struation, in the irritability 
of stomach of children, and 
in other dyspeptic conditions 
in which nausea or vomiting 
are prominent symptoms, a 
drop of ipecacuanha wine 
taken every hour will often 
prove truly curative. At 



IPECACUANHA. 



313 



tartar emetic, being neither 
so prompt as the first, nor so 
nauseating as the second. It 
has been found by experi- 
ment to cause diminution of 
tactile sensibility and para- 
lysis of the lips, not unlike 
glossopharyngeal paralysis, 
and depending probably on 
exhaustion of the medulla 
oblongata by the vomiting 
act. 

II. Circulation Ipecacu- 
anha has no direct influence 
on the heart or circulation, 
save the usual depression fol- 
lowing nausea and vomiting. 

III. Respiration and Tem- 
perature No effect is pro- 
duced on the rapidity of the 
respiratory function, save the 
temporary acceleration usu- 
ally accompanying the act of 
vomiting. There seems no 
doubt, however, that ipeca- 
cuanha causes an increased 
secretion from the mucous 
membrane of the bronchial 
tubes. After poisoning by 
ipecacuanha, the lungs have 
generally been found in a 
bloodless condition in the 
early stages, followed by in- 
tense congestion. 



IV. Digestive and Secret- 
ing Organs — 1. — Stomach 
and Intestines — As already 
noted, ipecacuanha causes 
some irritation of the termi- 
nal filaments of the pneumo- 
27 



present this must be looked 
upon as one of the enigmas 
of therapeutics. 



III. Ipecacuanha is there- 
fore a most useful expecto- 
rant, thinning and diluting 
the pulmonary mucus, and 
thus facilitating its expulsion. 
It is hence almost universally 
employed in bronchitis, com- 
mon catarrh, winter cough, 
etc. It was formerly used, 
and with some alleged suc- 
cess, in hcemoptysis, 5-grain 
doses repeated at short in- 
tervals exerting a marked 
depressing effect, and thus 
checking the tendency to 
bleeding; but with the intro- 
duction of more effectual re- 
medies, this mode of treat- 
ment has now fallen into dis- 
use. 

IV. 1. Ipecacuanha is in- 
dicated in some overloaded 
conditions of the stomach, 
caused by excessive indul- 
gence either in food or drink ; 
and the dull aspect, coated- 



314 



IPECACUANHA. 



gastric nerve distributed to 
the stomach, and thus sets 
in motion the reflex machin- 
ery necessary to produce vo- 
miting. On the mucous lin- 
ing of the intestinal canal, 
also, its effects are undoubted, 
as indicated by its action in 
disease ; but we are at pre- 
sent unable to give any sat- 
isfactory explanation of its 
often marvellous influence 
over dysentery in its various 
forms. 



tongue, foul breath, head- 
ache, and nausea, may be 
promptly relieved by a good 
emetic dose. 

In acute dysentery, ipeca- 
cuanha is now looked upon as 
a never-failing specific. It 
must here be taken in full 
doses, from 15 to 20 grains 
being given at once and re- 
peated in two hours ; and al- 
though the first dose may be 
rejected by the stomach, 
toleration is speedily estab- 
lished, and no more vomiting 
is produced. Some authori- 
ties recommend a previous 
administration of laudanum 
to quiet the stomach. Docker 
goes further than this, and 
advises GO to 90 grains in one 
dose, which often seems to cut 
short the disease. Let the 
patient after taking this re- 
main quietly on his back for 
at least 10 or 12 hours before 
repeating the dose, and even 
then we must be guided by 
symptoms. 

Under this treatment the 
pain and tenesmus rapidly 
subside, the motions regain 
natural color and consistence, 
and the patient makes a satis- 
factory recovery. 

In cases of dysenteric diar- 
rhoea so often met with in 
this country, and more espe- 
cially in children, ipecacu- 
anha in much smaller doses 
is also a very effectual rem- 
edy, the indications for its 
use being any appearance of 



IPECACUANHA. 



315 



2. Liver. — Ipecacuanha 
is a powerful hepatic stimu- 
lant. It increases slightly 
the secretion of intestinal 
mucus, but has no other 
apparently stimulating in- 
fluence on the intestines. The 
bile secreted under its influ- 
ence has the normal compo- 
sition. 

3. Skin. Ipecacuanha 

promotes slightly the cuta- 
neous secretion, independent- 
ly of the tendency to perspira- 
tion usually attending the ac- 
tion of emetics. 



blood or mucus in the stools, 
with pain and straining. In 
the more ordinary forms of 
diarrhoea, however, it is quite 
useless. 

2. It has therefore been 
given in the form of pill, and 
combined with other reme- 
dies, to relieve the sluggish 
digesfioji caused by a defi- 
ciency of bile. 



3. Ipecacuanha combined 
with opium, in the form of 
"Dover's Powder," is a 
well-known and tolerably 
effectual diaphoretic, much 
used in chronic rheumatism 
and feverish attacks. 



Mode of Elimination, etc. 

It is probable that as much of the ipecacuanha as remains 
after the action of vomiting is eliminated from the system 
by the biliary and intestinal secretions. 

Mode of Administration. 

The action of ipecacuanha wine is so notoriously uncer- 
tain, that, when we wish to obtain the full emetic effect of 
the drug, it is best to have recourse to the freshly powdered 
root (15 to 30 grains, or 1. to 2. 6m.), remembering, however, 
that children will bear unusually large doses. 

In the treatment of dysentery, also, we shall derive most 
advantage from the use of the powder ; and in ordinary cases 
of dysenteric diarrhoea we may give from -^ to 2 or 3 grains 
in combination with compound tragacanth powder. 

Vinum ipecacuanhas, in doses of from n^x to 3j> ls an 
almost invariable ingredient of cough mixtures. 

[Emetia, the alkaloid of ipecacuanha, is not officinal, but 
is an efficient emetic in doses of gr. T ^ to ^ (.005 to .01 Gin.).] 



316 



JALAP. 



JALAPA— JALAP. 

[ The tuber of Exogonium purga (Bentharn, Botanical Register), 
Ipomoea Jalapa (NuttalV) , U. S. 

Dose, in substance, gr. x-xxx (.60 to 2. Gm.). 

Officinal Preparations, U. S. 

Extraetum Jalapae. Dose, gr. v-x (.30 to. 65 Gm.). 

Pulvis Jalapae Compositus (jalap 1 part, cream of 
tartar 2 pts.). Dose, gr. xx-3j (1.30 to 4. Gm.). 

Resina Jalapae. Dose, gr. ij-iv (.12 to .25 Gm.). 

Tinetura Jalapae (powder *iij_Oj). Dose, 3j-ij (4. 
to 8. Gm.).] 



Physiological Action 

The action of jalap resem- 
bles that of scammony, only 
ditfering in being less irri- 
tant and more effectual in 
promoting the flow of watery 
fluids from the bowels. 

Rutherford points out that 
it is a " moderately powerful 
hepatic, and a powerful intes- 
tinal stimulant." 



Therapeutical Action. 

Jalap is undoubtedly one 
of our best hydragogue ca- 
thartics, and is much used in 
cerebral lesions, in kidney 
disease, where the excretion 
of effete products threatens 
to become suspended, and 
when dropsy is setting in ; 
in such cases smart purgation 
by pulv. jalap, co. will often 
produce striking benefit. 

In cardiac disease, also, 
when the right side of the 
heart is engorged by emphy- 
sema or bronchitis, free ca- 
tharsis will unload the dis- 
tended and laboring organ, 
and relieve the condition of 
intense dyspnoea, with the 
cold and livid surface and 
indications of approaching 
death. Jalap also acts well 
as an ordinary or habitual 
purgative, and is generally 
prescribed in the form of the 
compound powder, containing 
cream of tartar. 






BUTTERNUT — JUNIPER. 317 

[JUGLANS— BUTTERNUT. 

The inner bark of the root of Juglans cinerea, U. S. 

Officinal Preparation, U. S. 

Extractum Juglandis. (Dose, as a laxative, gr. v-x ; 
as a purgative, gr. xx-xxx (.30 to 2. Gm.). 

Juglans is an indigenous cathartic resembling rhubarb in 
its property of evacuating without debilitating the bowels. 
Mild and efficient in its action, it is well adapted to habitual 
constipation. It may be given in decoction, or in the form 
of the officinal extract.] 



JUNIPERTJS— JUNIPER. 

[ The fruit of Juniperus communis, U. S. 
Officinal Preparations, U. S. 

Infusum Juniperi (berries gj to Oj). Dose, f Jij-iv 
(64. to 128. Gm.). 

Oleum Juniperi. Dose, gtt. v-xv (.30 to 1. Gm.). 

Spiritus Juniperi Compositus (oil f5jss in Oviij). 
Dose, f'5ij-iv (8. to 16. Gm.). 

Spiritus Juniperi (oil fjj in Oiij). Dose, f3ss-j (2. 
to 4. Gm.).] 

Physiological Action. Therapeutical Action. 

Juniper stimulates the ac- Juniper is a good diuretic, 
tion of the kidneys, but, like generally used in combina- 
many other remedies of its tion with other drugs, and 
class, only increases the flow acting either when swallowed, 
of urine where dropsy exists, or inhaled in the form of 
It has been shown that in a vapor, 
healthy man the quantity of 
the urine is actually dimin- 
ished, whilst the urea is in- 
creased. 

[When an overdose is 
given, even strangury and 
total suppression may result. 
In small doses it is a gentle 
stimulant and stomachic] 

27* 



318 



D 



KINO — RHATANY. 








I£. Spiritus juniperi 
Potassii acetatis 
Spiritus aetheris nitrosi 
Decocti scoparii [Br;] 

S. Dose, f §j ter die. 


f §ss ; 

3iss ; 

fft ; 

f Jviij ; 


or 

1 1 

a 
a 


16 

6 

32 

256 


Gm. 

a 


iuretic mixture. 











M. 



KINO— KINO. 



[ The inspissated juice of Pterocarpus Marswpium (De Candolle) and of 
other plants, U. S. 

Officinal Preparation. 

Tinctura Kino (sss to Oj). Dose, f3j (4. Gm.).] 

Physiological Action. Therapeutical Action. 

Kino is astringent in vir- It may therefore be used 
tue of the tannin which it in diarrhoea and other cases 
contains. where astringents are indi- 

cated, but it seems to have 
no special advantage over 
other remedies of the same 
class. 



KRAMERIA—RHATANY. 

[The root of Kramer ia triandra {De Candolle), U. S. 
Dose in substance, gr. xx (1.30G m.). 

Officinal Preparations, U. S. 

Extractum Krameri®. Dose, gr. v-x (.30 to .65 
Gm.). 

Extractum Krameriffi Fluidum. Dose, gtt. xx 
(1.30 Gm.). 

Infusum Krameris (3j to Oj.). Dose, f gj-ij (32. to 
64. Gm.). 

Syrupus Krameria?. Dose, f^ss 16. Gm.). 

Tinctura Krameria3 (^iij to Oj). Dose, f'Jj-ij (32. 
to 64. Gm.).] 

Physiological Action. Therapeutical Action. 

Krameria has powerful as- Rhatany lias been used 

tringent properties, due, no with success in dysentery and 

doubt, to the tannin which it diarrhoea,, but is probably 






LACTUCARIUM — LAPTANDRA. 319 

contains. [It is also gently inferior to many other reme- 
tonic, and is much esteemed dies of the same class, and 
in Peru in treatment of bowel is therefore but seldom em- 
affections.] ployed. [It is frequently 

added to chalk mixture, in 
the treatment of diarrhoea of 
relaxation.] 



[LACTUCARIUM— LACTUCARIUM. 

The concrete juice obtained from Luctuca sativa, by incision and 
spontaneous evaporation, U. S. 

Dose, gr. xx (1.30 Gm.). 
Officinal Preparation, U. S. 

Syrupus Laetucarii (|j to Oj). Dose, f ^ss (16. 
Gm.). 

Lactucarium, or Lettuce-opium, is a feeble narcotic, and 
is considered slightly laxative and diuretic. It has been 
used as a substitute for the other narcotics in phthisis and 
in diseases of children.'] 



[LAVANDULA—LAVENDER. 

The flowers of Lavandula vera (De Candolle), U. S. 
Officinal Preparations, U. S. 

Oleum Lavandulae. Dose, gtt. iij-x (.20 to .60 Gm.). 

Spiritus Lavandulae. Dose, f 5ss-j (2. to 4. Gm.). 
Enters into Mistura Ferri Composita. 

Spiritus Lavandulae Compositus, Dose, 3j-iv 
(4. to 16. Gm.). 

Lavender is a carminative, but is rarely used except in 
combination. The compound spirit is its most elegant pre- 
paration, and is a very agreeable stomachic and cordial. 
The oil is used in perfumery.] 



[LEPTANDRA— LEPTANDRA. 

The root of Leptandra Virginica [Xuttall), U. S. 

Culver's root is emetic and cathartic, and is also consid- 
ered cholagogue. Dose of the powdered root, gr. xx to 3j 



320 LEMON. 

(1.30 to 4. Gra.). In small doses (gr. ij-v, or .12 to .30 
Gm.), it is said to resemble rhubarb. The fluid extract 
(not officinal) is aperient in doses of" n^x to f 5j (*60 to 4. 
Gm.).] 



LIMONES— LEMON. 

[The fruit of Citrus Limonum (De Cundolle), U. S. 

Limonis Cortex. Lemon Peel. 
Limonis Suecus. Lemon Juice. Dose, fjj-iv (32. 
to 12K Gm.). 

Oleum Limonis. Oil of Lemon. Used for flavoring. 
Acidum Citrieum. Citric Acid. 

Officinal Preparations, U. S. 

Spiritus Limonis. Used for flavoring purposes. 

Mistura Potassii Citratis. Neutral mixture. Dose, 
f oj-ij (32. to 64. Gm.). 

Syrupus Limonis. As a vehicle. 

Spiritus Ammonise Aromatieus. Dose, fjss-j 
(2. to 4. Gm.). 

Syrupus Acidi Citriei. As a vehicle.] 

Constitutional Action. 

Lemon-peel is in some measure tonic and anti-spasmodic, 
and is a useful flavoring ingredient, but lemon-juice has some 
important properties which are purely therapeutical, and 
cannot be explained by any action which it possesses over 
the healthy organism. 

In the first place Ave must rank its antiscorbutic virtues, 
acting as it does both by preventing and by curing the dis- 
ease, and by its universal use afloat nearly stamping out the 
ravages of what used to be an almost invariable attendant on 
long voyages at sea. The occurrence of scurvy to any ex- 
tent on board ship is now looked upon as a clear indication 
that the regular administration of lime or lemon-juice has 
been neglected, and that the crew has been attacked by a 
painful and dangerous disease, the absolute preventability of 
which experience has amply confirmed. Various explana- 
tions have been given of the cause of scurvy, and there is no 
doubt that it is usually associated with an absence of fresh 
meat and vegetables from the diet scale. Dr. Garrod, how- 



FLAXSEED. 321 

ever, goes further, and teaches that the essence of the dis- 
ease lies in a deficiency of the potash salts ; whilst Mr. 
Morgan, of Dublin, is no less convinced that the absence of 
phosphoric acid is the real cause — both agreeing in this, 
however, that the presence of this special ingredient in 
lemon-juice explains its superiority over citric acid, which is 
in no degree an antiscorbutic. It is unfortunate that lime- 
juice is bulky, and liable to become solid at low tempera- 
tures, and must be also administered in such considerable 
doses as to give some excuse for its occasional neglect on 
expeditions where every ounce of extra weight entails in- 
creased toil and danger. It is to be hoped that some more 
convenient and portable means of using this invaluable drug 
may yet be introduced. 

Lemon-juice was formerly vaunted as a specific for acute 
rheumatism, and although this has not been confirmed by 
experience, there is no doubt that persons afflicted with 
chronic rheumatic pains may often derive benefit from taking 
a tablespoonful of this agreeable remedy two or three times 
a day with their meals. Lemon-juice has also been called a 
refrigerant, but its sole claim to this title rests upon the 
great facility with which we may construct refreshing effer- 
vescing draughts by its aid. 

[Linimenta. 

The officinal Linments are — 

Linimentum Aconiti Liniruentura Chloroformi 

" Aimnonipe " Plumbi Sabacetatis 

" Calcis " Saponis 

" Camphorae " Terebinthinse.] 

" Cantharidis 



LINUM— FLAXSEED. 

[ The seed of Linum usitatissimum, U. S. 

Oleum Lini. Flaxseed oil (Linseed oil). 
Lini Farina. Ground flaxseed (Linseed meal). 

Officinal Preparations, U. S. 

Infusum Lini Compositum. As a demulcent. Dose, 
fo.i-iv (32. to 128. Gm.). 

Ceratum Resina? Compositum. Deshler's Salve. 
Linimentum Calcis. Canon oil. (For burns.)] 



FLAXSEED. 



Local Action. 



Physiological. 

Linseed meal, in the form 
of poultice, is the most con- 
venient and effectual way of 
applying continuous moist 
warmth to the surface of the 
body. Thus used, it relieves 
pain, relaxes spasm, and is 
generally soothing and agree- 
able to the feelings of the pa- 
tient. By relaxing the super- 
ficial vessels, a poultice may 
be in some measure antiphlo- 
gistic, and may also relieve 
the congestion of internal or- 
gans by drawing blood to the 
cutaneous surface and pro- 
moting perspiration there. 



Therapeutical. 

A linseed poultice is a very 
soothing and effectual appli- 
cation in all acute affections 
of the lungs. Not only does 
it relieve pain, but it keeps 
up a warm equable temper- 
ature, and rests the affected 
organ by restricting in some 
degree the movements of the 
chest walls. It may also be 
used with advantage in peri- 
tonitis, in colic, in various 
inflammatory affections of the 
throat, and in boils, abscesses, 
etc., where, if it does not suc- 
ceed in arresting the suppu- 
rative process, as occasionally 
happens, it facilitates and 
hastens the breaking down of 
inflammatory products into 
pus, and thus encourages the 
process of ripening. After 
the opening of the abscess, 
poultices cannot be recom- 
mended, as they are nauseous 
and dirty, and we would 
much rather advise the case 
to be treated on the antiseptic 
principles of Mr. Lister. 

Linseed oil is an old-fash- 
ioned treatment for burns, 
and, combined with lime- 
water, was formerly exten- 
sively used under the name 
of Carron oil. 



Internal Use. 
An infusion of linseed is Under the name of linseed 



rather soothing in 



character, tea, this infusion is much 



LITHIUM. 323 

probably owing to the muci- used in domestic medicine 
lage which it contains. as a soothing remedy for 

coughs. 

Mode of Administration. 

When used as an application in pleurisy or pneumonia, a 
poultice must extend fairly round the chest ; it should be 
about a quarter of an inch thick, and must be changed not 
seldomer than every two hours, as it soon tends to become 
dry, hard, and uncomfortable. It is best made by slowly 
adding the meal to boiling water, stirring vigorously mean- 
while, and afterwards incorporating with it a certain amount 
of olive oil, which prevents its adhering to the surface. [A 
piece of oiled silk should be placed outside of the poultice to 
retain its warmth and moisture.] Occasionally its use seems 
to irritate the skin, and cause a crop of small boils and painful 
pustules, and it must, therefore, as a general rule, be avoided 
in moist cutaneous affections. 



LITHIUM—LITHIUM. 

[Lithii Carbonas. Carbonate of Lithia. Dose, gr. 
iij-vj (.20 to .40 Gra.). 

Lithii Citras. Citrate of Lithia. Dose, gr. v-x (.30 
to .Go Gin.).] 

Physiological Effects. Therapeutical. 

Lithia forms a very soluble Lithia is, therefore, a valu- 
salt with uric acid, probably able remedy for gout, and 
in the blood, and, therefore, uric acid gravel, given either 
prevents the deposition of in the form of effervescing 
chalky formations in the tis- lithia water, lithii carbonas, 
sues. or lithii citras. 

It also causes an increase It, therefore, acts as a diu- 
in the urinary secretion. retic perhaps more powerfully 

than any of the other alkaline 
salts. 



324 



LOBELIA. 



LOBELIA— LOBELIA. 

[The leaves and tops of Lobelia hiflata, U. S. 

Officinal Preparations, U. S. 

Aeetum Lobeliae (fgij to Oj). Dose, from gtt. x to 
f 3j-ij (.65 to 8. Gm.). 

Tinetura Lobelias (f sjij to Oj). Dose, the same. 

Antidotes. 

The stomach should be washed out with warm solution of 
tannic acid, and symptoms of collapse • treated as they arise, 
by stimulants, frictions, counter-irritants, sinapisms, and 
anodynes.] 

Local Action. 



Lobelia possesses no local action. 

Internal Actions. 



Physiological. 

1. Brainand Nervous Sys- 
tem In large doses, lobelia 

frequently causes headache 
and giddiness, and may even- 
tually extinguish life by para- 
lyzing the respiratory centre. 

2. Heart and Circulation. 
— Lobelia depresses the ac- 
tion of the heart, and in this 
respect has a powerful affinity 
to tobacco. 

3. Respiration and Tem- 
perature As already men- 
tioned, lobelia in large doses 
is a respiratory depressant, 
but in ordinary medical prac- 
tice it seems to relieve spas- 
modic conditions of the bron- 
chial tubes. 

It lowers the temperature 
in some measure, on account 
of its diaphoretic action. 



Therapeutical. 



3. Lobelia is only used in 
medicine in this country as 
a remedy for various respi- 
ratory affections, and more 
especially spasmodic asthma. 
Its action here is apt to be 
uncertain, and it may unex- 
pectedly cause much nausea 
and discomfort ; but Ringer 
tells us that we may employ 
it with great confidence by 
giving much larger doses than 
are usually prescribed. 



LOBELIA. 



325 



Remember that its action 
in no way prevents the asth- 
matic attack, but merely cuts 
it short. 

4. Lobelia is never used 
as an emetic, being slow, un- 
certain, harsh, and exhaust- 
ins:. 



4. Secreting and Digestive 
Organs. — Lobelia has un- 
doubted emetic properties, 
and frequently causes vomit- 
ing, accompanied by much 
nausea and general depres- 
sion. 

Skin Lobelia excites the 

action of the skin. 

Kidneys Lobelia is said 

to promote the excretion of 
watery fluids by the kidneys. 



Dose. 

Ringer tells us that the close laid down in our usual text- 
books is much too small, and that we may freely administer 
a drachm of the ethereal tincture [same strength as tinct. 
lobelia, U. S.] every hour, or ten minims every ten minutes, 
with advantage, immediately before and during the asthmati- 
cal paroxysm. [The vinegar of lobelia is said to be the best 
preparation for internal use.] 

The great drawback to its use is the occasional unpleasant 
symptoms following its administration, and which can be, 
unfortunately, neither foreseen nor prevented. 

[Liquores. 

The officinal Liquors are — 

Liquor 

Iodidi " 



Liquor Ammonii Acetatis 

" Arsenici Cliloridi 

" " et Hydrarg 

" Barii Cliloridi 

" Calcii Cliloridi 

•' Calcis 

" Ferri Cliloridi 

11 " Citratis 

" " Nitratis 

" " Subsulphatis 

" " Tcrsulpliatis 

" Gutta-perclise 

" Hydrargyri Nitratis 
28 



Iodinii Compositus 
Magnesii Citratis 
Morphise Sulpliatis 
Plumbi Subacetatis 

" " Dilutus 

Potassse 
Potassii Arsenitis 

' k Citratis 

' ' Permanganatis 
Sodse 

" Clilorinatse 
Sodii Arseniatis 
Zinci Cliloridi.] 



326 



LYCOPODIUM — MAGNESIUM. 



[LYCOPODIUM— LYCOPODIUM. 

The sporules of Lycopodium claratum, and other species of 
Lycopodium, U. S. 

Lycopodium is an extremely light, very fine powder, of 
a delicate yellow color, inodorous, tasteless, and very inflam- 
mable, so that it flashes like gunpowder when thrown into 
the flame. It is used as a dusting powder for chafing, but 
should not be used when the skin is broken. It is also em- 
ployed to coat pills in pharmacy.] 



MAGNESIUM—MAGNESIUM. 

[Magnesii Carbonas. Carbonate of Magnesia. Dose, 
5ss-gj (2. to 32. 6m.). 

Magnesii Sulphas. Sulphate of Magnesia (Epsom 
salt.) Dose, o ss -j (16. to 32. Gm.)„ 

Officinal Preparations, U. S. 

Magnesia. Dose, 5J-i v (4. to 16. Gm.). 
Troehisei Magnesias (each containing gr. iij). 
Liquor Magnesii Citratis. Dose, f5ij-iv (32. to 
128. Gm.).] 

Internal Uses. 



Magnesia and its carbon- 
ate have a great capacity for 
saturating and neutralizing 
acid, and secondly, on becom- 
ing converted into bicarbon- 
ate by the carbonic acid of 
the intestines, they produce 
a mildly laxative effect. 

Sulphate of magnesia acts 
much more powerfully, and 
causes profuse watery evacu- 
ations, and its action may be 
thus explained : — 

In virtue of its low diffu- 
sive power, it does not readily 
find its way into the blood, 



They are therefore antacid, 
and relieve pain or heart- 
burn, and are also gentle 
purgatives, much used, more 
especially for children. Their 
tendency, however, to form 
concretions, when employed 
too long, limits their use in 
this respect. 

Sulphate of magnesia is a 
very commonly used purga- 
tive in doses of from 5j t° 
§ss in simple constipation, 
in the early stages of small- 
pox and feverish conditions, 
in chronic lead-poiso7iing y 



MAGNESIUM. 327 

but, remaining in the intes- and, combined with iron, in 
tines, it attracts and firmly many atonic conditions of the 
retains the watery fluid it system, 
finds there, and thus prevents 
its reabsorption. But, in ad- 
dition to this, and to increas- 
ing the intestinal secretion, 
recent experiment has shown 
that it also actually with- 
draws fluid from the veins, 
as proved by the rapid way 
in which a small portion of 
intestine isolated from the 
rest of the tube becomes filled 
with watery fluid after the 
introduction of sulphate of 
magnesia. The experiments 
of Rutherford have shown 
that magnesium sulphate is a 
powerful stimulant to the in- 
testinal glands, and that this 
action may at once be checked 
by paralyzing the sensibility 
of the gut by a little lauda- 
num. 

Mode of Administration. 

As sulphate of magnesia is not only very nauseous, but, 
when taken alone, may cause griping, straining, or uncom- 
fortable abdominal distension, it is usually prescribed in com- 
bination with senna, cardamom, and liquorice, as in the 
mist, sennse co. [Br.], or with a little acid and sulphate of 
iron, both of which seem to increase its purgative properties; 
and it is well to remember that free dilution also seems to 



M. 



in 


ce its effects. The following are good form 


uke :- 


R. 


Magnesii snlphatis 


m ; 


or 


64 


Gin. 




Syrupi zingiberis 


f§ss; 


1 1 


16 


tt 




Infusi rosse corn. q. s 


ad f gviij 


it 


256] 


a 


S. 


§j tertiis horis. 










R 


Magnesii sulphatis 


?i.i ; 


or 


64( 


Gm. 




Ferri snlpliatis 


gr. xxiv ; 


11 


1160 " 




Acidi sulphurici diluti 


f'5i.i ; 


a 


8 


u 




Infusi quassias q. s. 


ad f §viij ; 


u 


256) 


(( 



Misce. fiat inistura, cujus capiat unciara unam oinni mane. 



328 MANGANESE — ARROWROOT. 

£ Magnesii sulphatis fi.1 5 or 64[ Gm. 

Magnesii carbonatis 311 ! " 8 " 

Syrupi zingiberis f §j ; " 32 " 

Aquae merit, piperita q.s. ad f.^viij ; " 256 " 
Misoe, fiat mistura. Sumat unci am unam quartis lioris ad 

efl'ectum, i:>liiala prius bene agitata. 



[MANGANESIUM-— MANGANESE. 

Manganesii Oxidum Nigrum. Black oxide of 
Manganese (used in making oxygen, chlorine, and aqua 
chlorini) has been administered in doses of gr. iij-xx (.20 to 
1.30 Gm.). 

Manganesii Sulphas. Sulphate of Manganese. Dose, 
gr. y-xx (.30 to 1.30 Gm.). 

Internal Effects and Uses. 

Sulphate of manganese acts as a purgative in doses of 
5j-ij (4. to 8. Gm.), and in smaller doses has cholagogue 
properties. It has been used as a substitute for iron, as a 
hcematinic. Dr. Hammond reports its successful use in 
chorea. In divided doses it has been given in gastralgia, 
pyrosis, and indigestion.'] 



MANNA— MANNA. 

[The concrete saccharine exudation, in flakes, of Fraxinus Ornus and 
of Fraxinus rotundifolia, U. S.] 

Internal Effects and Uses. 

Has very slight purgative properties. [It is generally 
given in infusion combined with senna, but may be used 
alone boiled in milk for children, to whom its sweet taste 
makes it acceptable. Dose for a child, 3j-iij (^« to 12- Gm.).] 



[MARANTA— ARROWROOT. 

The fecula of the rhizome of Maranta Arundinacea, U. S. 
Enters into Trochisci Ipecacuanhae. 

Uses. 

Arrowroot is demulcent, and forms an agreeable article of 
diet for the sick and for infants.] 



MARBLE — GERMAN CHAMOMILE. 329 

MARMOE— -MAKBLE. 

Native, white, granular Carbonate of Calcium, U. S. 

Used as a source for Carbonic Acid Gas, and in making 
Aqua Acidi Carbonici, and Liquor Calcii Chloridi. (See 
Calcium.)] 



[MARRUBIUM—HOREHOUND. 

The leaves and tops of Marrubium vulgare, U. S. 

Used as a domestic remedy for coughs and colds and as a 
diaphoretic, in the form of decoction (5J to Oj), syrup, and 
candy.] 



MASTICHE—MASTIC. 

\_The concrete resinous exudation from Pistacia Lentiscus, U. S. 

Enters into Pilulae Aloes et Mastiches.] 

This is only used as a tilling for decayed teeth in dental 

surgery. 



MATICO— MATICO. 

[The leaves of Arlanthe elongata (Miguel), U. S. 
Officinal Preparation, U. S. 

Extraetum Matico Fluidum. Dose, f5ss-j (2. to 
4. Gm.).] 

Matico is only used externally as a local application for 
the arrest of hemorrhage : and it is generally believed that 
it acts mechanically by the roughly-reticulated under surface 
of the leaf entangling the blood and forming clots. No suc- 
cess has attended its internal administration. [In the form 
of the fluid extract, Matico has been highly recommended 
in hemorrhages and diseases of mucous membranes, includ- 
ing go?iorrhcea and leucorrhoea.2 



[MATRICARIA— GERMAN CHAMOMILE. 

The flowers of Matricaria Ckamomilla, U. S. 

Resembles chamomile in its properties, but is rarely used 
in America.] 

28* 



330 HONEY — SPEARMINT. 

[MEL—HONEY. 

A saccharine liquid prepared by Apis mellifica, U. S. 

Officinal Preparation, U. S. 
Mel Despumatum. Clarified Honey. 

Uses. 

Enters into Confectio Aromatica, Confectio Opii, Con- 
fectio Rosre, Oxymel (Br.), Mel Rosre, Mel Sodii Boratis, 
Pilula Ferri Carbonatis, Pilulre Quinire Sulphatis, Tinctura 
Cardamomi Composita, and Tinctura Opii Composita. 

Its agreeable taste and demulcent qualities make honey 
a useful vehicle for distasteful powders, and render it an 
acceptable addition to gargles. Purified honey is a good 
excipient for pills, and forms the basis of the Mellita, which 
are used chiefly in washes for the throat and mouth. J 



[Mellita. 

The officinal Honeys are: Mel Rosas, Mel Sodii Boratis.] 



[MENTHA PIPERITA— PEPPERMINT. 

The leaves and tops of Mentha piperita, U. S. 

MENTHA VIBIDIS— SPEARMINT. 

The leaves and tops of Mentha viridis, U. S. 

Officinal Preparations, U. S. 

Aqua Mentha? Piperita?. Used as a vehicle. 

Oleum Mentha? Piperita?. Dose, gtt. iij-x (.20 to 
.65 6m.). 

Spiritus Mentha? Piperita?. Dose, gtt. x-xx (.Q5 
to 1.30 Gm.). 

Troehisci Mentha? Piperita?. 

Aqua Mentha? Viridis. Used as vehicle. 

Oleum Mentha? Viridis. Dose, gtt. iij-x (.20 to 
.65 Gm.). 

Spiritus Mentha? Viridis. Dose, gtt. x-xx (.65 to 
1.30 Gm.). 



MEZEREON — HORSE-MINT. 331 

Peppermint and spearmint are favorite stimulant stom- 
achics, and are much used as vehicles in mixtures. The 
troches of peppermint are a popular carminative. The oil of 
peppermint is used sometimes as a counter-irritant in neural- 
gia, following the Chinese practice.] 



MEZEREUM— MEZEREON. 

\_The bark of Daphne Mezereum and of Daphne Gnidium, U. S. 

Officinal Preparations, U. S. 

Extraetum Mezerei Fluidum (used in Ung. 
Mezerei). 

Unguentum Mezerei (a stimulant dressing).] 

Decoetum Sarsaparillae Compositum. Dose, 
f 5iij— iv (96. to 1.28 6m.). 

Extraetum Sarsaparillae Compositum Flui- 
dum Dose, 5^s-j (2. to 4. 6m.). 

This drug is never used save as a constituent of the de- 
coetum sarsaparillae co. 



[Misturae. 

The officinal Mixtures are — 

Mistura Ammoniaci Mistura Cretan 

" Amygdala? " Ferri Composita 

" Assafcetida? " Glycyrrliizse Composita 

" Chloroformi " Potassii Citratis.] 



[MONARDA— -HORSE-MINT. 

The leaves and tops of Monarda punctata, U. S. 

Officinal Preparation, U. S. 
Oleum Monardae. Dose, gtt. ij-iij (.12 to .20 6m.). 

Effects and Uses. 

The oil is used in domestic practice for sick stomach and 
flatulent colic ; like the other mints, it is stimulant and car- 
minative. Applied to the skin it is rubefacient, even vesi- 
cant, and has been employed as counter-irritant in chronic 
rheumatism, infantile paralysis, and in low fevers.'] 



332 MUSK — MACE. 

[MOSCHUS— MUSK. 

A peculiar, concrete substance obtained from Moschus Moschiferus, U. S. 
Internal Effects. 

Has undoubted antispasmodic powers, but has been almost 
entirely discarded on account of its high price and frequent 
adulteration. It may be given in doses of gr. v-xv (.30 to 
1. Gm.), in hysterical convulsions, hiccough, in low fevers 
and delirium tremens. An efficient substitute for musk is 
Castoreum, see page 205.] 



[Mueilagines. 

The officinal Mucilages are — 

Mucilago Acaciae Mucilago Tragacanthse 

" Sassafras Medulla? " Ulmi.] 



MYRISTICA—NUTMEG. 

[The kernel of the fruit of Myristica fragrans (Houttuyn, Nat. Hist.) 

U.S. 

Officinal Preparations, U. S. 

Spiritus Myristieae. Dose, f 5j (4. Gm.). 
Oleum Myristieae. Volatile Oil of Nutmegs. Dose, 
gtt. ij-iij (.12 to .20 Gm.).] 



MAC1S— MACE. 

The aryllus of the fruit of Myristica fragrans (Houttuyn, Nat. Hist.), 

U. S. 

Enters into Acetum Opii, Pulvis Aromaticus, Spiritus 
Ammonias Aromaticus, Spiritus Lavandulae Compositus, 
Spiritus Rhei Aromaticus, Trochisci Cretee, Trochisci Mag- 
nesias, and Trochisci Sodii Bicarbonatis.] 

Nutmeg is rarely used in medicine save as a flavoring in- 
gredient. [The dose of Nutmeg or Mace in substance is 
gr. xv (1. Gm.). With its aromatic qualities, nutmeg unites 
considerable narcotic power, and in doses of 3 ij-iij (8. to 12. 
Gm.) has produced stupor and delirium.] 



MYRRH. 333 



MYRRHA— MYRRH. 

[A gum-resinous exudation from Balsamodendron Myrrha (Nees, 
Beschreib. Officinel. Pflanzcn), U. S. 

Dose, in substance, gr. x-xxx (.Qo to 2. Gm.). 

Officinal Preparations, U. S. 

Tinctura Myrrhae (giss to Oj). Dose, fjss-j (2. to 
4. Gm.). 

Tinctura Aloes et Myrrhae. Dose, f 5j->j (4. to 
8. Gm.). 

Pilulae Aloes et Myrrhae. Rufus's Pills. 

Also enters into Mistura Ferri Composita, Pilulae Ferri 
Composite, Pilule Galbani Composite, and Pilulre Rhei 
Composite.] 

Local Uses. 

Physiological. Therapeutical. 

Myrrh is astringent, and It is a useful addition to 

checks excessive secretion gargles in relaxed or ulcer- 
from mucous surfaces. ated conditions of the throat ; 

it is a good application to 
spongy or unhealthy gums, 
as in mercurial salivation ; 
and it often forms one of the 
active constituents of lotions 
for foul ulcers, where it gently 
stimulates the granulating 
surface, and corrects the 
fetor of discharges. 

Internal Uses. 

Like all the gum balsams Myrrh has occasionally 
and resinous substances, been used as a stimulant in 
myrrh may possess in some chronic bronchitis, but prac- 
degree the power of stimu- tically its application in medi- 
tating mucous surfaces. Tra- cine is now restricted to the 
dition and the habit of pre- administration of the various 
scribers have also invested it forms of pill in amejiorrhoea ; 
with some supposed influ- and here it is impossible to 



334 NUX VOMICA. 

ence over the uterus ; but no separate its action from the 
trustworthy evidence has ever aloes with which it is invari- 
been brought forward on this ably combined, 
point, and it is more than 
probable that its emmena- 
gogue influence is quite secon- 
dary to the other drugs in 
combination with which it is 
prescribed in these cases. 

fy. Alummis 5i.i I or 8 Gm. 

Tincturse myrrhae t'5ij ; " S " 

Infusi rosse comp. qs.ad f^x; " 320 : " 

Misce, fiat gargcirisma. 



NECTANDRA— BEBEERU BARK. 

[ The bark of Nectranda Rodiei Schomburgli) , U. S."] 

The bebeeru bark possesses some of the physiological pro- 
perties of quinine. Thus it arrests the movements of the 
white blood-corpuscles, and checks the development of bac- 
teria; but unfortunately it does not in any way fulfil the 
same therapeutical indications, save acting as a tonic in virtue 
of its bitterness. 

[Like cinchona, it contains several alkaloids, the principal 
one having received the name of bebeeria, a sulphate of which 
is officinal in the Ph. Br., but not officinal in the United 
States. The antiperiodic close of the sulphate of beberia is 
gr. xx-3j (1.30 to 4. Gm.). (It should not be confounded 
with berberina, the active principle of the simple bitters.)] 



NUX VOMICA— NUX VOMICA. 

[ The seed of Strychnos Nux Vomica, U. S. 

Officinal Preparations, U. S. 

Tinetura Nueis Vomicae (^iv-Oj). Dose, n^x 
(.65 Gm.). 

Extractum Nueis Vomicae. Dose, gr. J to J 
(.015 to .03 Gm.). 

Strychnia and Strychnia^ Sulphas. Dose, gr. 
B i_ to T V (.002 to .005 Gm.).] 



NUX VOMICA. 335 

Poisonous Effects. 

Strychnia kills by inducing hyper-excitability of the reflex 
functions of the spine, with violent tetanic spasms, leading 
to death by exhaustion or suffocation. The fatal event may 
take place in a few minutes if the dose be a large one, and 
the minimum quantity required to destroy life is about half 
a grain. Contrary to the habits of other poisonous drugs, 
strychnia acts most rapidly and efficiently when given by 
the rectum. 

Antidotes. 

In a case of strychnia-poisoning, we may first administer 
tannin, which places the drug in an insoluble form, then, 
after evacuation of the stomach, it will be necessary to try 
the physiological antidotes. These are chloral, bromide of 
potassium, Calabar bean, and nicotia [or tobacco enemata], 
although the use of the last-mentioned remedy must be con- 
ducted with extreme caution. Finally, we may have recourse 
to artificial respiration. 

[Tests. 

Strychnia may be recognized by rubbing a small por- 
tion with a few drops of sulphuric acid containing one-hun- 
dredth of its weight of nitric acid. No change ensues ; but 
the addition of a very small quantity of the peroxide of lead, 
or of bichromate of potassium, changes the solution to a blue 
color, then to a red, and in the course of a few hours to a 
yellow color. Commercial strychnia sometimes affords a red 
color, changing to a yellow, with nitric acid, owing to the 
presence of brucia. 

Brucia is colored red by nitric acid, and this color 
changes to violet by the addition of protochloride of tin. 
With chlorine it gives a red color. Sulphuric acid first red- 
dens brucia, and then turns it yellow and green.] 

Local Action. 
No special local action has been noted. 

Constitutional Action. 
1. Brain and Nervous Sys- 1. Nux vomica, and more 

tern. — No effect is produced especially strychnia, are ex- 



336 



NUX VOMICA, 



on the brain, the cerebral 
functions remaining unim- 
paired almost up to the close 
of a case of strychnia-poison- 
ing. 

The spinal cord, however, 
is early attacked, and violent 
and distressing tetanic spasms 
prove the irritating influence 
of the drug, more especially 
on the reflex excitability of 
that organ. 

In large doses, strychnia 
also paralyzes the efferent 
(motor) nerves, causing loss 
of power of voluntary move- 
ment. 

The vasomotor and proba- 
bly the respiratory centre are 
stimulated. 



2. Heart and Circulation. 
— Strychnia causes rise of 
arterial pressure and con- 
traction of the capillaries. 
Strychnia is an excellent 
remedy in some cases of 



cellent nervine tonics, acting 
well in simple debility, nerv- 
ous exhaustion, and inconti- 
nence of urine, and promot- 
ing the return of function 
after some forms of paraly- 
sis. When all inflammatory 
symptoms have subsided, 
strychnia may be prescribed 
in the hope of stimulating 
the spine to resume its duties, 
and restoring tone to mus- 
cles which long remained in 
a state of inactivity. Thus, 
in paraplegia, hemiplegia, 
diphtheritic paralysis, and 
wrist-drop, strychnia may 
well go hand in hand with 
galvanism when all evidence 
of irritation of the nervous 
structures has completely 
disappeared. Mr. Barwell 
has proposed subcutaneous 
injections of strychnia in in- 
fantile paralysis, using a 
large dose ( T \ to T \ gr., 
.005 Gm.), and forcing the 
fluid freely into the muscular 
structures. [To begin with, 
a much smaller dose should 
be exhibited. One-half a 
grain, by the mouth, has 
killed an adult.] 

In chorea it has been 
highly praised by Trousseau, 
Hammond, and others. 

[2. When given in small 
doses it is an excellent heart 
tonic, probably from an effect 
secondary to that upon the 
vaso-motor nerves.] 



NUX VOMICA 



337 



paralytic and emphysematous 
asthma. 

3. Respiration and Tem- 
perature. — The interference 
with breathing observed in 
strychnia - poisoning, and 
which usually terminates the 
life of the victim, is due to 
spasmodic fixation of the 
diaphragm and respiratory 
muscles. 

4. Digestive and Secreting 

Organs Strychnia has a 

tonic influence over the di- 
gestive process, aiding oxida- 
tion, removing the products 
of waste, and delaying putre- 
faction. 



4. Strychnia, and more 
especially nux vomica, are 
excellent tonics, improving 
the appetite in a marked 
degree; but, in addition to 
this, nux vomica is of great 
service in various dyspeptic 
conditions, relieving heart- 
burn, nausea, and flatulence, 
and being also a reliable 
remedy in sick headache and 
the vomiting of pregnancy. 
It is an excellent addition to 
purgative pill masses, improv- 
ing the tone of the muscular 
wall of the intestines and re- 
lieving constipation. 

Dose, Mode of Administration, etc. 

The dose of strychnia may be put at from ^ to y 1 ^ gr. 
(.002 to .005 Gm.j, and the liquor [Br.] is a convenient 
form, in doses of from o to 10 minims, added to any ordinary 
tonic mixture. We are usually advised to suspend its adminis- 
tration from time to time, as it is stated that uncomfortable 
twitchings and rigidity about the jaw may suddenly arise, 
giving evidence of the so-called "accumulation" of the drug. 

By hypodermic injection we are usually taught that gr. 
T ^y is the proper dose, and it is therefore difficult to under- 
stand why no poisonous results followed Barwell's somewhat 
heroic medication, the reason probably being that the strych- 
nia had been very imperfectly absorbed. 
29 



338 



NUX VOMICA. 



E^. Ferri sulpli. exsic. gr. xl; 

Quiniae sulpli. gr. xl 

Strycbiiiae sulpli. gr. ss ; 

Maiinae q. s. 

Fiant pilulae xx. Sumat unam ter die. 

A useful tonic pill. 

I£. Tinct. nucis vomicae f 5.1 ; 

Acidi nitro-muriatici diluti f ,^ij ; 

Spiritus cliloroformi f5i ; 

Infusi gentianae adffvj ; 

S. Dose, f §j ter die sumend. 

Yoy flatulent colic, taken after meals. 

B_. Ferri sulpli. 

Ext. nucis vomicae aa gr. ss ; 

Ext. aloes Barb. gr. iij ; 

Fiat pil. ante cibum sumend. 

A good " dinner pill." 



2:60 Gra. 
2160 " 
03 " 



4 

8 

4 

192 



Gm. 



M. 



M. 



103 Gm. 

20 " M. 



The officinal Oils are- 



[Olea. 



Oleum iEtbereum 

Amygdalae Amarae 

" Expressum 

Anisi 
Bergamii 
Cajuputi 
Campliorae 
Cari 

Caryophylli 
Chenopodii 
Cinnamomi 
Copaibse 
Cubebae 

Erigerontis Canadensis 
Fceniculi 
Gaultberiae 
Hedeomae 
Juniperi 
Lavandulae 
Limonis 
Lini 
Mentbae Piperitae 



OL 



m Mentbae Viridis 
Monardae 
Morrbuae 
Myristicae 
Olivae 
Origani 
Pimentae 
Ricini 
Rosae 

Rosmarini 
Rutae 
Sabinae 
Sassafras 
Sesami 
Succini 

" Rectificatum 
Tabaci 

Terebintbinae 
Tbeobromae 
Tbymi 
Tiglii 
Valerianae.] 



C0D-LTVER OIL. 339 

[Oleo-resinae. 

The officinal Oleo-RESins are — 

Oleo-resina Capsici Oleo-resina Lupulinae 

" Cubebse " Piperis 

" Filicis " Zingiberis.] 



[OLEUM .ETHEREUM— ETHEREAL OIL, U. S. 

Heavy oil of wine is a limpid, almost colorless, volatile 
fluid, of a pungent taste and vinous odor. Its solution in 
alcohol and ether is officinal as Spiritus iEtheris Compositus 
(see page 135, but it is never prescribed alone.] 



OLEUM MORRHUA— COD-LIVER OIL. 

[The fixed oil obtained from the livers of Gadus Morrhua and of other 
species, of Gadus, U. S. 

Local Actions. 

Cod-liver oil is not used in virtue of any local action, as 
its nauseous smell effectually prevents it from forming the 
basis of ointments or liniments. Being very readily absorbed 
by the skin, however, it is occasionally introduced into the 
system by this channel when the patient is unable to take it 
by the mouth. [Inunctions with cod-liver oil are very useful 
in cachectic and scrofulous infants. It has also been used 
in ophthalmic practice, instilled into the eye, to remove slight 
opacity of the cornea.] 

Constitutional Actions. 
Physiological. Therapeutical. 

1. Brain and Nervous 1. It is therefore specially 

System Cod-liver oil can indicated in all nervous affec- 

only be said to act on the tions dependent on debility, 

nervous system by improving such as neuralgia, some 

its nutrition and supplying forms of insanity, asthma, 

the fatty ingredients neces- whooping-cough, etc. 

sary for growth and repair. 

2. Circulation. — It has a 2. It is therefore much 
tonic influence on the circu- used in simple debility, in 



340 



COD-LIVER OIL. 



lating organs, by improving 
the quality of the blood, in- 
creasing the number of red 
blood - corpuscles, both in 
health and in some patholo- 
gical conditions, if it is well 
borne, and strengthening the 
heart-muscle. 

3. Respiration and Tem- 
perature No special physi- 
ological influence is exerted 
on either of these functions. 
[In addition to its value as 
a hydro-carbon in simply 
nourishing the body, it is al- 
terative by virtue of a small 
proportion of iodine, bro- 
mine, and phosphoric acid 
which it contains, associated 
with certain biliary princi- 
ples, in a manner, perhaps, 
best adapted to secure their 
absorption and assimilation.] 



4. Digestive and Secreting 
Organs. — It has been proved 
by experiment that animal 
are much more digestible 
than vegetable oils, probably 
on account of containing bile, 
and cod-liver oil is the most 
readily assimilated of all. 
After being emulsified by the 
pancreatic juice, it comes in 
contact with the bile, which 
distinctly increases its power 
of passing through moist ani- 
mal membranes; and it is 
probable also that the biliary 
principles incorporated in its 



convalescence from acute ill- 
ness, in ancemia, tertiary 
syphilis, and other weakened 
conditions of the system. 



3. Under this heading we 
may place, for convenience, 
the wonderfully restorative 
effects of cod-liver oil in 
chronic lung disease, but 
more especially in the va- 
rious forms of pulmonary 
phthisis. It is beneficial in 
asthma and chronic bronchi- 
tis, but in consumption it 
really seems to be directly 
curative. It may be given 
with advantage in all stages, 
and under its use patients 
often rapidly gain flesh, and 
not only manage to hold the 
disease at bay, but even oc- 
casionally seem to escape 
from its clutches. 

4. Cod-liver oil is almost 
invaluable in diseases de- 
pending on defective nutri- 
tion, as in all scrofulous 
conditions, such as strumous 
ophthalmia, caries of bones, 
chronic joint- affections, glan- 
dular enlargements, etc. ; also 
in rickets and all the wasting 
disorders of childhood, in 
senile atrophy and decay, in 
chronic rheumatism, in all 
the ulcerative varieties of 
shin disease, and in advanced 
constitutional syphilis. Va- 
rious attempts have been 



COD-LIVER OIL. 341 

own structure aid in enabling made to explain the actions 
it to be easily absorbed by of the oil by means of certain 
the lacteals. Its action on special ingredients which it 
the system now is to improve contains; but none of these 
the general constitutional have been successful, and we 
tone, to evolve force and heat, cannot at present do more 
and to aid in supplying those than attribute its restorative 
fatty elements which are so influence to its ready diges- 
essentially requisite for the tibility and nutritive proper- 
construction and repair of ties. 
the tissues. 

Cod-liver oil occasionally 
causes nausea, vomiting, and 
diarrhoea, and it has been 
shown to increase in some 
measure the biliary secretion. 

Mode of Elimination. 

The greater part of the oil is absorbed into the system, but 
a little is given off by the feces; and it is well to watch the 
evacuations of children under its influence, to see whether 
any undigested oil escapes, this indicating an overdose. 

Drawbacks. Mode of Administration. 

Cod-liver oil occasionally produces so much nausea, eruc- 
tation, and discomfort, as to compel us to suspend its admin- 
istration ; but most patients, and more especially children, 
speedily grow accustomed to its use. An eruption of acne 
sometimes is caused by the passage through the cutaneous 
glands of some of its acrid constituents. It is advisable to 
prescribe it in small doses directly, or, even better, an hour 
after meals, or at bed-time, to give it with some light tonic, 
and to suspend it from time to time, more especially in hot 
weather, or when bilious symptoms supervene. It may well 
be given in combination with a little alcohol, beaten up with 
the froth of porter, with mucilage, or lemon-juice, or with 
from tti^x to f'5j of aether puris, which, Dr. B. Foster tells 
us, and which I have amply confirmed by experience, aids 
digestion by stimulating the pancreatic secretion ; but if the 
pale oil is used, very few persons will be found entirely re- 
bellious to its use. Children, as a rule, take it well, but if 
they prove obstinate we may give it with orange wine, or in 
the following combination : — 

29* 



342 



OLIVE 


OIL. 






^ . Olei morrliuae 


f^ss; 


or 


16 


Mucilaginis acacise 


f.^ij; 


it 


64 


Saccliari 


5ij; 


" 


8 


Spiritus lavandulae comp. 
Aquae 
f ^ss pro dosi. 


rr\xx; 
ffss; 


t( 


1 
16 



Gm. 



30 



M. 



[In private practice, Dr. Foster prefers to give the follow 
ins mixture : — 



I£. Potassii bicarb. 5J ss- iJ > 

Acidi hydrocyan. dil. TT^xij-xvj 

Spt. aetheris 3J ss- iiJ 5 

Aquae q. s. ad 3 v iij ? 

Dose, % ^j ter in die smuat.] 1 



6 
256 



Gm. 



75 



M. 





65 Gm. 




06 " 


2 


(< 


16 


<< 



Black coffee forms a good medium for adults, or we may give 
the oil floating on beer, porter, or on the following mixture : — 

I£. Acidi nitrici diluti rt\x ; oi 

Acidi hydrocyanici dilut. "Htj-ij ! " 

Tincturae aurantii 15 ss l " 

Aquae f §ss : " 16 " M. 

The dose should never exceed half an ounce. 

[A pancreatic emulsion of cod-liver oil, and an emulsion 
with the lacto-phosphate of lime, or one with lime-water 
flavored with oil of bitter almonds, are largely used for 
children, although not officinal. Equal parts of extract of 
malt and cod-liver oil make a mixture that is readily taken 
by children.] 



OLEUM OLIV^E—OLIVE OIL. 

[The fixed oil obtained from Olea Europoea, U. S. 

Olive oil is nutritious and laxative, and is occasionally 
used for children as a substitute for castor oil. Dose, for an 
adult, f^ij-iv (64. to 128. Gm.). It is a useful remedy for 
all kinds of irritant poisoning except phosphorus in sub- 
stance. It is used largely in pharmacy.] 

Olive oil is only used externally as an emollient applica- 
tion, and as the basis of various liniments. 



1 [Fothergill's Handbook of Treatment, Phila., 1878.] 



CASTOR OIL. 



343 



OLEUM RICINI— CASTOR OIL. 

[The fixed oil obtained from the seeds of Ricinus communis, U. S. 

Enters into the Officinal Preparations, Collodium cum 
Cantbaride and Collodium Flexile. 
Dose, 5J-5J (4. to 32. Gm.).] 

External Uses. 

Castor oil is a substance of such bland and unstimulating 
quality, that, were its smell less offensive, it might form a 
valuable external agent in certain cases. It is, however, 
occasionally used as a soothing application to the eye when 
extreme temporary irritation has been set up by abrasion of 
the corneal epithelium. Castor oil will purge when rubbed 
into the skin. 



Internal Uses. 



Physiological. 

Castor oil gently stimulates 
the peristaltic movements of 
the intestinal canal, and 
slighly augments the fluid 
secretions of the gut. Some 
amount of astringent action 
generally follows the purga- 
tive action of the drug. 

The seeds are very irri- 
tating, and cause gastro- 
intestinal irritation, three 
having proved fatal to an 
adult. 



Therapeutical. 



Castor oil is a mild and 
efficient cathartic, emptying 
the intestines without causing 
griping or discomfort. It is 
therefore useful in all cases 
where we simply wish to un- 
load the bowels; but it is not 
a good habitual purgative 
from the subsequent constipa- 
tion produced. This astrin- 
gent action, however, gives it 
a special advantage in the 
treatment of diarrhoea, many 
cases of which depend on 
the presence of irritating 
matters in the intestinal 
canal ; and under such cir- 
cumstances, common sense 
naturally indicates the pro- 
priety of expelling the excit- 
ing cause. Dr. Geo. John- 
son, however, goes further 
than this, and advocates the 



344 OIL OF AMBER. 



"eli mi native" treatment of 
all dian 

cholera. 



all diarrhoeas, as well as of 



Dose and Mode of Administration. 

Although the best castor oil has but little actual flavor, it 
leaves a greasy, sickly sensation on the palate, which is ex- 
ceedingly unpleasant. It is therefore important to give it in 
some form of combination, and we find floating the dose in a 
glass between two strata of whiskey or brandy [and cinnamon 
water] to be an effectual plan, or we may make use of the 
following formula? : — 

ty. 01. ricini fgss; or 16j Grn. 

Mucilaginis acaciae, " 

Syrupi simplicis, aa f 3'j ; " 8! " 

Aquae ciimamomi q. s. ad f §ij ; " 64{ " M. 

Fiat liaustus statirn sumendus. 

I£. 01. ricini f ^ iij ; or 12j Gm. 

Tinct. opii n\,x ; " j 65 " 

Syrupi zingiberis f 5j ; " 4 " 

Aquae mentli. pip. q. s. ad f §ij ; " 64i " M. 
Fiat haustis statim sumendus. 

Either makes a good prescription for the diarrhoea of irri- 
tation. 



OLEUM SUCCINI— OIL OF AMBER. 

The volatile liquid obtained by the destructive distillation of amber, U. S. 

Officinal Preparation, U. S. 

Oleum Suceini Rectifieatum. Rectified oil of 
amber. Dose, gtt. x-xx (.65 to 1.30 Gm.). 

The oil of amber is stimulant and antispasmodic, and has 
been recommended in bronchitis, hysteria, and obstinate hic- 
cough, and is also used externally, diluted with sw r eet oil, as 
a sedative and rubefacient for whooping-cough, or for infan- 
tile convulsions, as in the mixture recommended by Dr. Jos. 
Parrish : — 



$. Olei suceini rectificati, 

Tincturae opii, aa f ^ss ; or 16 

Olei olivae, 

Spiritus viui Gallici, aa f ^ij ; " 64 

To be rubbed along the spine.] 



Gm. 

M. 



CACAO BUTTER — CROTON OIL. 



845 



OLEUM THEOBROMJE— CACAO BUTTER. 

^The concrete oil of the kernels of the fruit of Theobroma Cacao, U. S.~] 

Oil of theobroma, being a firm, solid, and agreeable sub- 
stance, is much used in the manufacture of suppositories, and 
enters into — 

Suppositoria Acidi Carbolici (each gr. j of carbolic acid.) 
" " Tannici ( " gr. v of tannic acid.) 

" Aloes ( " gr. v of purified aloes.) 

" Assafeetidre ( " gr. v of assafcetida.) 

" Belladonna ( " gr. ^ extract of belladonna.) 

" Morphiae ( " gr. \ sulphate of morphia.) 

" Opii ( " gr. j extract of opium.) 

riumbi ( " gr. iij plumbi acetatis.) 

gr. iij plumbi acetatis and 
gr. \ extract, opii.)] 



Plumbi et Opii ( 



[OLEUM TIIYML— OIL OF THYME. 

The volatile oil obtained from Thymus vulgaris, U. S. 

The oil of thyme is said to furnish the greater part of the 
commercial oil of origanum. It is aromatic and counter- 
irritant, the oil being used almost exclusively as a local ap- 
plication, and as an ingredient in opodeldoc, the linimentum 
saponis camphoratum of former editions of the Pharmaco- 
poeia.] 



OLEUM TIGLII— CROTON OIL. 

[ The fixed oil obtained from the seed of Croton Tiijlium, U. S. 
Dose, gtt. i-iv (.OG to .25 Gm.).] 



Physiological. 

The topical application of 
croton oil to the skin causes 
a good deal of irritation, fol- 
lowed by the appearance of 
a copious crop of papules, 
gradually developinginto pus- 
tules. Dr. Tilbury Fox has 



Local Action. 

Therapeutical. 
The local application of 



liniments containing croton 
oil was in former years a fa- 
vorite mode of using counter- 
irritation in various chronic 
lung-affections, and it is still 
employed, more especially in 



346 



CROTON OIL. 



described a symmetrical ery- 
thema of the face following 
this local employment ; and 
it is said that the addition of 
an alkali favors the develop- 
ment of the counter-irritant 
properties of the drug. 



public practice. But its draw- 
backs are, that it has a ten- 
dency to overact on tender 
or irritable skins, and the 
pustules are liable to leave 
cicatrices, so that it is diffi- 
cult to believe it in any way 
superior to other and milder 
applications. Dr. Liveing 
recommends it highly in ring- 
worm, giving the caution 
that, as it causes much irri- 
tation, it should not be ap- 
plied to a surface larger than 
a florin at a time, and should 
never be used in children 
under ten years of age. 



Internal Action. 



When taken internally, 
croton oil produces much irri- 
tation of the intestines, run- 
ning on, if the dose be suffi- 
ciently large, into a very fair 
imitation of the symptoms of 
cholera-poisoning, with vom- 
iting, extreme purging, col- 
lapse, and acute inflammation 
of the intestines. It is a hepa- 
tic stimulant of very feeble 
power. 



Croton oil, then, is a dras- 
tic purgative, valuable in cer- 
tain cases on account of its 
rapid and powerful action. 
Thus in apoplexy and other 
cerebral affections, where it 
is of importance to obtain an 
immediate and thorough evac- 
uation of the bowels, and in 
some conditions of obstinate 
constipation, we find consid- 
erable advantage from its cau- 
tious use. 



Mode op Administration, etc. 

Croton oil has an acrid and irritating flavor, and is best 
given in the form of pill or rubbed up with sugar. Garrod, 
however, tells us that it may well be prescribed in combina- 
tion with castor oil, and, in case the patient is unable to 
swallow, it may be placed on the back of the tongue. 

In an extreme case we might expect to obtain some purga- 
tive effect from rubbing it into the skin, as it appears to act 
by absorption through this channel. 



opium. 347 

$. Olei crotonis n\,ij ; or f 12 6m. 

Micse panis q. s. M. 

Fiat pilula, statiin sumenda, et lioris duabus repetenda 
si opus sit. 

Or we may endeavor to keep its irritating properties in 
check by prescribing it in the following combination : — . 

fy. 01. crotonis TTliij or |20 Gm. 

Ext. colocynth. comp. gr. xx ; " 1,30 " 
Ext. belladonna gr. iij ; " J20 " 

Misce, divide in pil. vj, quarum snmat unam si opus sit. 

For external use, a very good liniment is contained in the 
British Pharmacoepia. 



OPIUM—OPIUM. 

[ The concrete juice obtained from the unripe capsules of Papaver som- 
niferum, by incision and spontaneous evaporation, U. S. 

Dose, gr. j (.06 Gm.). 

Officinal Preparation, U. S. 

Acetum Opii (gr. j in ttLviss), Black drop. Dose, 
!H,v-vij (.30 to .45 Gm.). 

Confeetio Opii (gr. 1 in 3G). Dose, gss (2 Gm.). 

Extractum Opii (double strength of* opium). Dose, 
gr. ss (.03 Gm.). 

Emplastrum Opii (extract 1 in 16). 

Suppositoria Opii (extract of opium gr. ss). 

Suppositoria Plumbi et Opii (plumb, acet. gr. iij ; 
extr. opium gr. ss). 

Pilula? Opii (each gr. j). 

Pilula Saponis Composita (mass 20 per cent, 
opium). 

Pulvis Ipecacuanhas Compositus (Dover's Pow- 
der, gr. 1 in 10). Dose, gr. x (.65 Gm.). 

Tinetura Opii (gr. j in rrLxiij). Dose, r^xiij (.80 
Gm.). 

Tinetura Opii Aeetata (gr. j in ni^x). Dose, n^x 
.65 Gm.). 

Tinetura Opii Camphorata (gr. j in f gss). Dosp, 
f*5j to sj (1. to o2. Gm.). 



348 opium. 

Tinetura Opii Deodorata (gr. j in n^xiij). Dose, 
r^xiij (.80 Gm.). 

Troehisei Glycyrrhizas et Opii (gr. 1 to 20). 

Troehisei Morphias et Ipecacuanhas (each gr.^). 

Liquor Morphias Sulphatis (gr. j in f §j). Dose, 
f 3j (4. Gm.). 

Suppositoria Morphias (each gr. ss). 

Vinum Opii (gr. j in it^ v i i j ) . Dose, n^viij (.50 Gm.). 
( Morphias Acetas ) ^ , L 

Morphia 15ESS SgSL I (*>• -<^ 

Poisonous Action. 

When opium has been given in a poisonous dose, the re- 
sulting sleep gradually grows deeper, the breathing becomes 
heavy and stertorous, the face is flushed, swollen, and dusky, 
the pupils contracted to mere points, distension of the right 
side of the heart still further prevents the return of blood 
from the engorged lungs, and paralysis of the respiratory 
centre finally causes death by suffocation. Much difficulty 
may occasionally attend the diagnosis of opium-poisoning 
from (1) alcoholic coma, where, however, the pupils are 
usually dilated ; (2) from urasmic coma, where an examina- 
tion of the urine, if practicable, might clear up our doubts; 
and (3) from apoplectic effusion in the pons Varolii, where 
the symptoms are usually so similar as to render an absolute 
diagnosis, under certain circumstances, impossible. After 
death we find well-marked congestion of the brain. 

Treatment and Antidotes. 

When summoned to a case of opium poisoning, the first 
indication must be to evacuate the stomach, and this is best 
effected by the stomach-pump, as the vomiting centre is too 
much paralyzed by 'narcosis to allow of its effective stimula- 
tion by emetics. We then try to counteract the tendency to 
sleep by cold affusion, irritation of the skin, strong coffee, 
galvanism, and walking the patient about, and, finally, we 
may cautiously use atropine as the physiological antidote. 
Although evidence comes to us from good observers of 
opium-poisoning checked by the antagonistic action of atro- 
pine, reports and opinions differ much on this head, and some 



OPIUM. 



349 



authorities hold that atropine in certain proportions may 
even intensify the action of morphia. 

Professor Bennet believes that atropia may be of service 
by contracting the vessels of the brain, and limiting the ten- 
dency to cerebral congestion. 

As a last resource, we may have recourse to artificial 
respiration. 

Local Action. 



Physiological. 
It seems very doubtful 
whether opium can be ab- 
sorbed through the unbroken 
cuticle. We are told that 
opium inspectors in India 
will remain for hours with 
their arms plunged up to the 
elbows in the inspissated ex- 
tract, and that no narcotic 
effect is produced; but it is 
difficult, on the other hand, 
to believe that opium is en- 
tirely devoid of a property 
which belladonna possesses 
in so remarkable a degree. 
Sir Henry Thompson is also 
strongly of opinion that the 
bladder cannot absorb opium. 



Therapeutical. 
Fomentations with the de- 
coction of poppy-heads, and 
with other preparations of 
opium, have long been re- 
cognized as efficient means 
for the relief of pain in vari- 
ous inflammatory conditions, 
as hemorrhoids, erysipelas, 
conjunctivitis, etc. ; but as 
we cannot bring forward evi- 
dence of absorption of the 
drug, we must merely attrib- 
ute this soothing influence to 
the thorough application of 
moist heat. 



Internal Actions. 



I. On Nervous System 

1. Brain — In small quan- 
tity, or temporarily as the 
occasional preliminary action 
of a truly narcotic dose, 
opium is gently exciting to 
the brain, the intellectual 
faculties becoming generally 
stimulated, and the imagina- 
tion more vivid. To this, 
however, rapidly succeeds a 
30 



I — 1. Opium, being the 
most certain narcotic known, 
is very largely prescribed in 
a great variety of cases. In 
simple insomnia, in worn-out 
conditions of the nervous 
system, in acute fevers, such 
as typhus and typhoid, where 
delirium and sleeplessness 
constitute truly dangerous 
complications, in delirium 



350 



OPIUM. 



dulling or deadening effect, 
drowsiness supervenes, and 
deep sleep finally sets in, 
from which the patient wakes 
within a period of time, pro- 
portioned to the quantity of 
the drug administered. Head- 
ache, dryness of the mouth, 
and digestive disturbance are 
frequently experienced, and 
idiosyncrasy may in some rare 
cases interfere materially with 
sleep by bringing into special 
prominence the exciting or 
stimulating properties of 
opium. It is not quite clear 
in what precise way the nar- 
cotizing influence is in this 
instance produced ; but analy- 
sis would lead us to believe 
that contraction of the cere- 
bral vessels imitates natural 
sleep by inducing an anremic 
condition of the gray matter 
of the brain. This has been 
proved by the experiment of 
Hammond, who found that 
the brain is anaemic in sleep 
caused by a small dose, but, 
as the sleep passes into coma, 
after a large dose, venous 
congestion sets in. The re- 
sulting contraction of the 
pupil is probably central in 
origin, as it cannot be pro- 
duced by any local applica- 
tion of opium in any form. 

2. The conductivity and 
irritability of the sensory 
nerves are much diminished, 
so that pain is felt with less 
intensity. 



tremens, in the later stages of 
severe smallpox, in menin- 
gitis, acute mania, and in 
numerous other diseased con- 
ditions, which the reader can 
readily recall, this invaluable 
drug does most essential ser- 
vice by procuring sound and 
refreshing sleep. 



2. And even when not 
given in truly narcotic doses, 
it may also lull the sufferer 
into slumber by benumbing 
the sensory nerves and re- 
moving pain. As a sedative, 



OPIUM. 



351 



3. The reflex function of 
the spinal cord is at first 
slightly increased, but subse- 
quently becomes lessened in 
degree, and the respiratory 
centre is weakened and finally 
paralyzed. In cold-blooded 
animals, as the frog, in which 
the cerebral are subordinated 
to the spinal functions, opium 
causes most violent tetanic 
convulsions. [This also hap- 
pens occasionally in children.] 



4. The sympathetic system 
of nerves is also primarily 



anodyne, or analgesic, it is 
indispensable in many pain- 
ful conditions, such as neu- 
ralgia, sciatica, cancer, bili- 
ary or renal calculi, labor 
after-pains, colic, etc., and, 
as we shall presently see, 
the subcutaneous injection of 
morphia is the most effectual, 
as it certainly is the most 
rapid and convenient mode 
of obtaining this action of 
the drug. 

Opium is also an excellent 
antispasmodic, and acts well 
by relieving irregular mus- 
cular contraction, as in the 
intestine causing colic, in the 
uterus tending to abortion, 
or exhausting after-pains, in 
spasmodic urethral stricture ; 
and its remarkable influence 
over some forms of obstinate 
ulceration must also be due to 
some nervous influence. 

3. Opium, having the pro- 
perty of arresting the mus- 
cular action of various organs, 
is our sheet-anchor in those 
terrible cases where rupture 
of the intestine, bladder, or 
uterus, has occurred, and 
where the only possible 
chance of recovery consists 
in most perfect rest of the 
viscera, encouraging the heal- 
ing process, and preventing 
the escape of irritating se- 
cretions into the peritoneal 
cavity. 



352 



OPIUM. 



excited and secondarily de- 
pressed. 

II. Vascular System. — 
The action of the heart is at 
first slightly quickened, but 
afterwards its beats become 
slower, the pulse fuller and 
firmer, and the arterial ten- 
sion raised, this effect being 
considered due to an influ- 
ence on the cardiac inhibi- 
tory nerves. It is noted, 
however, that shortly before 
death, in cases of opium-poi- 
soning, the pulse becomes 
feeble, rapid, and irregular. 
The stimulating action on 
the sympathetic nerves causes 
some contraction of the 
smaller vessels to accompany 
the use of moderate doses of 
opium. 

III. Respiration and Tem- 
perature The breathing 

tends to become slow from 
the paralyzing influence of 
opium on the respiratory 
centre, and at the same time 
the secretion from the bron- 
chial tubes is lessened. 

The temperature at first 
rises a little, but finally falls 
when sweating is established. 



IV. Digestive and Secret- 
ory Organs 1. Nausea oc- 
casionally follows the use of 



II. The subcutaneous in- 
jection of morphia has been 
advised by Dr. Clifford All- 
butt in angina pectoris, pal- 
pitation, and various painful 
cardiac conditions. Its con- 
tracting influence on the 
small vessels explains the 
antiphlogistic effect of opium 
in cases of peritonitis and 
other inflammatory condi- 
tions, as well as its power of 
checking coryza in its early 
stage. It also acts well as 
an astringent in some forms 
of hemorrhage, and more es- 
pecially that from the lungs. 



III. Opium is the most 
soothing remedy for coughs 
of all kinds, but more espe- 
cially that of phthisis. It is 
a valuable aid in spasmodic 
asthma and the early stages 
of acute pneumonia, but in 
the later stages we must be- 
ware of its power of checking 
secretion, and in bronchitis 
it may do harm by slowing 
the respiratory movements, 
causing sleep to interfere with 
the due emptying of the bron- 
chial tubes, and thus leading 
on to imperfect aeration of 
the blood and final suffoca- 
tion. 

IV 1. Opium is an ex- 
cellent astringent in diar- 
rhoea, dysentery, and British 



OPIUM. 



353 



opium, and constipation in- 
variably results from diminu- 
tion of the intestinal secre- 
tions, no less than arrest of 
the peristaltic movements of 
the canal. 



2. The salivary secretion 
is also diminished, causing 
dryness of the tongue. 

3. The urine is lessened 
in quantity, but opinions dif- 
fer as to the effect produced 
on its solid ingredients. 



4. The biliary secretion is 
checked. 

5. The secretion of the 
skin is increased, perspira- 
tion generally resulting, and 
we may say generally that 
opium checks all secretions 
but that of the skin. Elimi- 
nation takes place by the 
breath, sweat, urine, etc. 



[or sporadic] cholera, often 
succeeding where other re- 
medies fail, and for the re- 
lief of pain and tenesmus, 
nothing is better than the 
enema of the [Br.] Pharma- 
copoeia. In the diarrhoza of 
ulcerative processes, such as 
typhoid and phthisis, and the 
later stages of dysentery, it is 
truly invaluable. 



3. Opium is of great ser- 
vice in some cases of diabetes, 
checking the craving appe- 
tite, and lessening the secre- 
tion of sugar. 

We must beware of its use, 
however, in advanced cases 
of renal disease, where it 
acts injuriously by checking 
secretion and encouraging 
the retention of urea in the 
blood. 



5. Opium in some forms, 
but more especially Dover's 
powder, acts as an efficient 
diaphoretic. 



Cautions and Modes of Administration. * 

In giving opium we must remember that human beings, 
like the lower animals, are diversely susceptible to its in- 
fluence. Thus, ducks and pigeons can swallow large quanti- 
ties with impunity, whilst the horse and the dog rapidly fall 

30* 



354 opium. 

under its influence ; and although we can hardly lay down 
any general rules to guide us in practice, we shall find that 
some persons can take very heavy doses, whilst others are 
poisonously affected with unexpected rapidity. We must 
specially remember that children always bear opium badly, 
one drop of laudanum having proved fatal to an infant ; that 
anosmic persons also are said by Traube to be readily sus- 
ceptible. To guard ourselves as far as possible from risk, 
we shall do well to begin with a moderate dose ; and invari- 
ably to ask our patient whether he has ever taken it before. 

As the system seems rapidly to accustom itself to the use 
of opium, we require gradually to increase the dose, and so 
completely do persons habituate themselves to the pleasurable 
sensations derived, that they willingly brave the resulting 
languor and digestive disturbance, and take it in enormous 
quantities. De Quincey used to take as much as 320 grains 
daily, and from half a pint to a pint of laudanum is by no 
means an uncommon daily allowance. Although the Turks 
and Chinese are the principal victims of this habit, much 
opium is also consumed in this way in some parts of Eng- 
land, and moderate opium-eaters abound in all ranks of 
society. We must therefore be very careful to warn our 
patients from time to time of the absorbing nature of this 
practice, and of its enervating effects on mind and body ; 
and although it seems evident that continued good health is 
altogether incompatible with even moderate opium eating, 
and that its use by smoking is far more deleterious, still 
there is abundant evidence of the generally lowering ten- 
dency of the habitual use of this drug as an act of mere self- 
indulgence. 

As regards the various pharmaceutical preparations of 
opium, when we wish to produce sleep we generally prescribe 
the tincture in a medium dose, the pil. saponis co., or the 
extract ; whereas, if we merely wish to relieve pain, smaller 
doses may prove sufficient. 

The astringent action is best secured by small doses, which 
bring the stimulant properties of the drug into play ; and an 
incipient coryza may often be checked by 5 or 10 minims of 
laudanum, taken at bed-time. 

For diaphoretic purposes the combination with ipecacu- 
anha, as in Dover's powder (pulvis ipecacuanha? compositus), 
is of service ; and, for the relief of diarrhoea, we also call to 
our aid the astringent properties of chalk and kino, as in the 



f?u; 


or 


64 


Gm. 


f?ij; 


c< 


64 


a 


fgss; 


c< 


16 


a 


f§ss; 


(< 


16 


a 


*S; 


<( 


32 


" I 



opium. 355 

pulvis cretre aromaticus cum opio [Br.], and the pulvis kino 
compositus [Br.] ; or the enema opii [Br.] may be soothing, 
both in this condition and as allaying, by nervous sympathy, 
various painful conditions of the uterus and bladder. 

As an adjunct to cough mixtures, and as forming their 
really effective ingredient, we most conveniently prescribe 
opium under the form of either the tinctura camphorse com- 
posita or of the tinctura opii ammoniata [Br.], as in Prof. 
Christison's well-known formula : — 

I£. Syrupi scillse 

Aq. men tli. pip. 

Tine, opii ammoniata [Br.] 

Spiritus lavandulse comp. 

Syrupi f%}; " 32 " M. 

Dose, f §ss ter die. 

In diabetes we may push the drug boldly, to the extent 
even of from 6 to 8 grains a day. 

The many-sided actions of opium, which we have just de- 
scribed, are due to its complex constitution and to the large 
number of alkaloids which it contains. Of these, morphia is 
by far the most generally used, and in the form either of 
sulphate, the muriate, or the acetate, but more especially of 
the former, it has in very considerable measure superseded 
the crude drug, on which we were formerly obliged to de- 
pend. Its principal differences from opium are as follows : — 

It is less astringent and antiphlogistic, and, interfering 
less with secretion, its use is not attended by so much head- 
ache, constipation, and dryness of tongue. It is more directly 
narcotic and anodyne, and is therefore a more convenient 
remedy when we wish merely to promote sleep or relieve 
pain. 

Its bulk is smaller than that of opium, and it is devoid of 
smell. 

The action of the heart becomes slower, and the arterial 
tension is raised. 

The respiration may become irregular from a depressing 
action on the vagi. 

The functions of the spinal cord are stimulated, and hence 
we occasionally meet with restlessness and muscular twitch- 
ings, which in some of the lower animals run on into true 
convulsions. 

Irritability of the bladder is often observed, and trouble- 
some itching of the skin, depending, in some cases, on the 



356 opium. 

development of a minute papular or vesicular eruption. Some 
years ago a favorite mode of using morphia was by what is 
known as the endermic method, in which the powder was 
sprinkled over the raw surface of a blister; but this has now 
been almost entirely superseded by the hypodermic syringe. 
This ingenious little instrument enables us to inject a small 
quantity of morphia in solution beneath the skin, and the 
relief to suffering is usually immediate, and sometimes per- 
manent. It matters little whether we introduce the remedy 
into the immediate neighborhood of the painful spot, our only 
caution being to avoid the vicinity of large bloodvessels or 
nerves, and to plunge the nozzle or needle of the syringe 
fairly through the skin into the adjacent cellular substance, 
preferably by perpendicular puncture. Some smarting occa- 
sionally follows the entrance of the fluid, which should be 
very slowly pumped in, and inflammation and abscess may 
occasionally be produced; but these accidents are rare, and 
the sting of the primary puncture may readily be obviated 
by freezing the skin with ether-spray. These injections are 
now very largely practised for the relief of pain, and more 
especially in facial neuralgia, sciatica, lumbago, in the pas- 
sage of biliary or renal calculi, in cancer, and in a vast 
range of diseases where acute suffering is the main symptom, 
we are enabled to give our patients temporary, and sometimes 
permanent, relief. So great, indeed, is the popularity of this 
mode of treatment, that a new school of opium-eating, so to 
speak, has been formed, and morphia-injections have unfor- 
tunately been practised to a great extent as a mere develop- 
ment of self-indulgence. We must, of course, be very careful 
not to give even the most casual or indirect encouragement 
to such disastrous habits. 

Some caution is always requisite in prescribing these injec- 
tions for the first time, as not only severe sickness and vomit- 
ing have followed their use in many cases, but great prostra- 
tion, with failure of the heart's action, and even death. We 
must therefore carefully watch our patient for some time after 
the completion of the little operation. We must never begin 
with a larger quantity than the sixth of a grain ; and we are 
told, on good authority, that the combination of t Jq of atropia 
to each dose of morphia will effectually obviate all risk of 
these unpleasant consequences. For injection we may use 
either the injectio morphias hypodermica [Br.] (containing 
1 gr. of the acetate in every 12 minims), or the elegant and 



opium. 357 

convenient gelatine disks prepared by Messrs. Savory and 
Moore at the suggestion of Dr. Sansom, remembering that 
morphia acts in this way three times more powerfully than 
when taken by the mouth. For internal use we may pre- 
scribe either salt, remembering, however, the varying sus- 
ceptibilities of different persons, and the fact that so small a 
quantity as half a grain has caused death ; or we shall find 
the liquor morphia? hydrochloratis [Br.] or acetatis [Br.], 
containing half a grain to the drachm, a convenient prepa- 
ration. 

Most of the other alkaloids contained in opium are merely 
subjects for physiological curiosity. 

1. Codeia, however, is now frequently used, not for its 
narcotic properties, which are feeble and transient, but for 
an undoubted soothing influence which it exerts over various 
painful affections of the kidney. It is also an established 
remedy in cases of diabetes, checking the secretion of sugar, 
and arresting, in some measure, the progress of the disease, 
its feeble narcotic properties here giving it a decided advan- 
tage over opium. It is also a useful remedy for the wearing 
cough of phthisis. Dose 1 to 10 or even 15 grains (.06 to 
1. Gm.), which large doses have even been prescribed with 
marked advantage in diabetes by Pavy and others. 

2. Narceixe possesses only one-eighth of the narcotic 
properties of morphia, and is never used in medicine. 

3. Cryptopia is one-fourth as powerful as morphia, and 
in addition to its hypnotic properties it causes in the lower 
animals peculiar illusions of vision, with a tendency to con- 
vulsive action. It also is never used. 

4. Paramorphia or Thebaia is purely excitant, and in 
doses of 1 grain it causes tetanic spasms. 

5. Narcotixa has no narcotic properties, but has some 
power as an antiperiodic. 

6. Papaverine is narcotic. 

7. Mecoxixe is feebly narcotic. 

[By the action of hydrochloric acid upon morphia at an 
elevated temperature (140° C), it is transformed into a new 
base, ApomorpMa, which is derived from morphia by the re- 
moval of a molecule of water. (Matthiessen.) It is not an 
alkaloid pre-existing in opium.] 

Apomorphia is a powerful emetic, generally used by 
subcutaneous injection, in doses of -^ gr. (.004 Gm.). 



358 PAREIRA BRAVA. 

[ORIGANUM—COMMON MARJORAM. 

The herb of Origanum vulgare U., S. 

Officinal Preparations. 

Oleum Origani. Dose, gtt. ij-v (.12 to .30 Gm.). 

The oil of origanum is rarely used, being largely super- 
seded in commerce by the oil of thyme. It is an aromatic 
stimulant. Origanum in infusion lias been used as a dia- 
phoretic and emmeuagogue, and externally as a fomenta- 
tion.] 



[OS— BONE. 

Introduced as the source of Calcii Phosphas Praecipitata 
and Sodii Phosphas.] 



OVUM— EGG. 
[ TJie egg of Phasanius Gattus, U. S. 

Used in pharmacy in making emulsions, and is an ingre- 
dient in Mistura Chloroformi.] 

White of egg is of use as an antidote to various corrosive 
poisons, as perchloride of mercury ; and the yelk (vitellus) 
has nutritive properties. 



[PAPAVER— POPPY CAPSULES. 

The nearly ripe capsules of Papaver somniferum, U. S. 

Occasionally, though rarely, employed in decoction or 
cataplasm ; and the Syrupus Papaveris (Br.) is sometimes 
given to children, but is an uncertain preparation.] 



PAREIRA— PAREIRA BRAVA. 

[The root of Cissampelos Pareira, U. S., but according to Hanbury 
and other authorities the origin is more correctly given as the root 
of the Chondodendron Tomentosum. 

Officinal Preparations. 

Extractum Pareirae Fluidum. Dose, f5ss-j (2. 
to 4. Gm.). 

Infusum Pareirae. Dose, f'gj-ij (32. to G4. Gm.).] 



PUMPKIN SEEDS — PHOSPHORUS. 359 

Local Action. 
Parefra has no local action. 

Constitutional Actions. 
Physiological. Therapeutical. 

Digestive and Secreting Pareira is used in various 

Organs Pareira acts in chronic bladder-affections, 

some measure, as a diuretic, but it seems to be very un- 
but its main influence is di- certain in its action, 
rected to the bladder, which 
it appears to stimulate and 
strengthen, improving the 
tone of its mucous lining, 
and lessening abnormal se- 
cretions. 



[PEPO— PUMPKIN SEEDS. 

The seeds of Cucurbita Pepo, U. S. 

Pumpkin-seeds are an efficient taenicide in doses of one or 
two ounces. The decorticated seeds, beaten into a paste 
with sugar or milk, are given in the morning fasting, fol- 
lowed, in an hour or two, by a dose of castor oil.] 



PHOSPHORUS— PHOSPHORUS. 

[Dose, in substance, gr. ^ to -jL (.001 to .005 Gm.).] 

Antidotes. 

There is no direct antidote, but turpentine is said to act 
as a prophylactic. [Old oil of turpentine is considered an 
antidote to phosphorus, followed by demulcents and evacu- 
ants. Large draughts of water containing magnesia in 
suspension are especially useful.] Sulphate of copper has 
also been proposed. 

(Phosphorus is not used externally.) 

Physiological Action. Therapeutical Action. 

1. Its action on the ner- 1. Phosphorus is therefore 

vous system is tonic and stim- a valuable agent in nervous 



360 



PHOSPHORUS. 



ulant, repairing the waste of 
tissue. 



2. On the circulation it 
acts in the first place as a 
stimulant ; the pulse rises and 
gains in fulness but not firm- 
ness, the face flushes, and 
eventually signs of peripheric 
capillary expansion ensue, 
ending in free perspiration. 
In large doses, however, it 
depresses to a dangerous de- 
gree the heart's action. In 
the anoemia of lymphadenoma 
the number of red blood-cor- 
puscles is increased. 

3. The temperature during 
the administration of phos- 
phorus at first rises slightly, 
next becomes secondarily 
lowered by three or four de- 
grees in consequence of the 
dilatation of the superficial 
capillaries and resulting eva- 
poration from the skin. 

4. On the urine phosphorus 
exerts the following in- 
fluence: Its quantity is in- 
creased, it becomes reddish, 
clouded with lithates, acquir- 
ing a violet smell, and, ac- 



debility, where the brain is 
weakened by anxiety, worry, 
overwork, or sexual excesses, 
and where too great amount 
of phosphates is excreted by 
the urine; and still more 
markedly in neuralgia, which 
has been shown by Anstie to 
depend on a feeble state of 
nerve tissue. 

Hammond has advised its 
use in the early stages of 
brain softening from over- 
exertion. 

2. Phosphorus may be 
given with decided benefit 
as a stimulant in typhoid con- 
ditions, where great feeble- 
ness exists, and as a general 
tonic it is of marked value, 
the appetite being sharpened, 
and a general sensation of 
well-being felt. 

Its depressing action on 
the heart, however, is a se- 
rious drawback, fatal cardiac 
syncope having on several 
occasions followed the ad- 
ministration even of moder- 
ate doses. 



PHOSPHORUS. 



361 



cording to B. von Bauer, its 
proportion of urea is mark- 
edly increased. 

Hematuria results from a 
poisonous dose. 

5. On the intestinal secre- 
tion no effect is produced by- 
small doses ; but, in the event 
of a large quantity being 
taken, great and persistent 
irritation of the stomach and 
intestines results, causing 
pain, vomiting, and purging. 
Jaundice is also a symptom 
of its poisonous action, and 
after death fatty degeneration 
of the liver is generally found. 
As biliary acids are found in 
the urine, it is believed that 
the jaundice is due to ob- 
struction of the ducts. 

6. To the skin, phosphorus 
acts in some measure as an 
irritant. Purpura occasion- 
ally appears as a symptom of 
its poisonous action. 



SI 



5. Much discussion has 
recently arisen respecting the 
remedial powers of phospho- 
rus in leucocythcemia and 
jiernicious ancemia, but the 
evidence is too conflicting 
(although opposing on the 
ay hole) to enable us to come 
to any decided opinion at 
present. The remedy is well 
worth trying, however, in 
these otherwise desperate 
cases, and Broadbent has 
recorded one remarkable suc- 
cess. 

6. On this account, be- 
cause of its stimulating the 
cutaneous circulation, phos- 
phorus has been given with 
success in the eruptive fevers, 
such as scarlet fever, measles, 
etc., to develop an insuffi- 
ciently developed, or prema- 
turely faded eruption, and on 
account of its chemical and 
physiological affinities to 
arsenic it has been found of 
service in the treatment of 
chronic eczema and psoriasis. 
Broadbent explains its action 
by its effecting a change in 
the blood through a general 
influence on cell-growth in 
all the tissues and organs, 
and of especial influence on 
cell-growth in the skin as the 
drug passes through it. 



362 



PHOSPHORUS. 



7. Its effects on the osseous 
tissue are remarkable, as it 
has the property of causing 
necrosis of the jaw-bone, and 
this used to be common in 
lucifer-match makers. Some 
interesting experiments by 
Wegner have recently shown 
a marked influence of phos- 
phorus in promoting the 
formation of bone ; for when 
given to growing animals the 
cancellous tissue was rapidly 
transformed into hard bone, 
and, even in the case of those 
fully developed, the medul- 
lary canal was sensibly dimin- 
ished by its use. Also, in 
cases of artificial fracture, not 
only was the resulting repair 
more rapid, but the quantity 
of bone thrown out was far in 
excess of the usual amount. 



7. The experiments of 
Wegner would indicate its 
use in rickets, but careful and 
repeated trials have only con- 
vinced me of* its great infe- 
riority to cod-liver oil in this 
disease. 



Poisonous Effects. 

These we have seen to consist of intestinal irritation, car- 
diac syncope, and death from exhaustion, the post-mortem 
disclosing fatty and parenchymatous degeneration of liver, 
muscles, and tissues generally. 1\ gr. has proved fatal. 
The blood becomes black, unduly liquid, and loaded with the 
products of tissue decomposition, such as uric acid, creatine, 
leucine, tyrosine, etc., this resulting from the ozonizing pro- 
perties of the poison. The degenerative changes are pro- 
bably due to the formation of fat from the albuminous con- 
stituents of the tissues themselves, by increased tissue 
change, or by diminished oxidation. 



Phosphorus is given out from the system principally by 
the urine, the drug being oxidized in the system and elimi- 
nated as phosphates. 



PHOSPHORUS. 303 



OONTRA-INDICATIONS AND DISADVANTAGES. 

We must generally feel our way in prescribing phosphorus, 
and begin with small doses, for some persons are more sus- 
ceptible than others to its over-action, and Anstie records a 
case in which three or four J^ gr. doses gave rise to long- 
continued epigastric pain. Nor must we forget its tendency 
to cause fatty degeneration of internal organs, which is due 
to the formation of fat in situ from their albuminous con- 
stituents, by increased tissue change and diminished oxi- 
dation. 

Mode of Administration and Dose. 

Much of our success, however, in giving phosphorus de- 
pends on the mode in which it is prescribed, and, as a general 
rule, capsules containing B T - grain are found to be a conve- 
nient medium. It also goes well with cod-liver oil, but it is 
very difficult indeed to devise any liquid formula by which 
it is prevented from becoming rapidly inert by oxidation. 
Most of the pill-masses are useless from being made with in- 
soluble materials which pass through the bowels unchanged. 

[Objections against the use of phosphorus in substance 
arise from its insolubility in the intestinal fluids, and the 
danger of the local action in the stomach. The ethereal so- 
lution or tincture of phosphorus may be given in combination 
with cod-liver oil, or, more acceptably, with the elixir of 
Calisaya bark ; and phosphorized resin (4 per cent.) offers a 
convenient means of administration in pill form, one grain 
being equal to gr. ^ of phosphorus.] 

The dose, speaking generally, is from ^\ to -g 1 ^ grain ; or 
we may give the phosphide of zinc, a very convenient and 
reliable preparation, much praised by Ashburton Thompson, 
[in pills containing] from J^ to \ grain [or, as recommended 
by Hammond, in combination with nux vomica : — 

$. Zinci pliospliid. gr. -^ ; 

Ext. nucis vora. gr. \. 

M. ft. pil. 

This is especially valuable in neuralgia.]] 



3G4 CALABAR BEAN. 

PHYSOSTIGMA— CALABAR BEAN. 

[ The seed of Pliysostigma venenosum (Balfour), U. S.~\ 
The ordeal bean of Old Calabar. 

[Officinal Preparation. 

Extraetum Physostigmatis. Dose, gr. ^ to ^ (.01 

to .02 Gm.). 1 

Eserine 2 (not officinal) or pliysostigma, may be used in 
solution (1 to 1000) to contract the pupils, or may be given 
internally in doses of gr. t Iq-^, (.0005—001 Gr.)]. 

Antidotes. 

In addition to the general principles of treating this form 
of poisonous action, we have here two physiological reme- 
dies at command — (1) atropia, which directly antagonizes 
the respiratory depression ; and possibly (2) strychnia, which 
stimulates the cord. 

Local Actions. 
Physiological. Therapeutical. 

When applied to the snr- Calabar bean is therefore 
face of the body, Calabar of use in ophthalmic surgery, 
bean exerts no special influ- to counteract the dilating 
ence, but when introduced to effect of belladonna, and to 
the eye it causes very com- prevent prolapse of the iris 
plete contraction of the pupil, in cases of corneal injury or 

ulceration. 

Constitutional Actions. 

T. On Nervous System. — 
1. The brain is quite unaf- 
fected, the mind, in cases of 
poisoning, remaining clear 
almost to the last. 

[' Extract of pliysostigma lias been given in much larger doses, 
as much as four grains every hour having been administered in 
tetanus, and even larger doses employed. Care should he taken, 
however, with these unusual amounts, as serious results may en- 
sue.] 

2 [According to Pohl and Harnack, pliysostigma contains two 
active principles, eserine, opposed to strychnia, and calabarine, re- 
sembling strychnia in its efl'ects upon the spinal cord.] 



CALABAR BEAN. 



365 



2. The spinal cord, how- 
ever, is especially attacked, 
and to a diminution of its 
motor power is due the mus- 
cular enfeeblement and final 
paralysis which affect those 
brought fully under the in- 
fluence of this drug. A still 
more remarkable result, how- 
ever, is the total abolition of 
all reflex activity, the most 
energetic stimulation failing 
to elicit the slightest response. 



2. The depressing action 
of Calabar bean on the re- 
flex powers of the spinal cord 
led Fraser to propose it as a 
remedy for tetanus, and this 
mode of treatment has proved 
very satisfactory in alleviat- 
ing the symptoms and check- 
ing the course of this terrible 
disease [and successful results 
have been reported from its 
employment.] 1 It is of great 
importance that the drug 
should be early used and 
vigorously pushed, as there is 
every reason to believe that 
the cord is free from marked 
pathological changes during 
the first period of the disease. 
Calabar bean has been 
tried without success in cho- 
rea, epilepsy, and other ner- 
vous disorders ; but recently 
Dr. Crichton Browne has 
expressed his conviction, 
founded on the observation 
of a few cases, that it may 
prove useful in the general 
paralysis of the insane. 

It has also been found to 
act as an effective antidote in 
strychnia-poisoning. 
3. Although, in the first 
stage of Calabar bean action, 
the motor nerves are unaf- 
fected, a secondary lessen- 
ing of their conductivity is 
noted, and, with reference 
to the sympathetic system, 
an early excitation is fol- 

[ x Case of Dr. Laycock in New Orleans Med, and Surg. Journal 
for March, 1882, cured by sulphate of eserine ; see also Philada. 
Med. Times, April 8, 1882, p. 475.] 

31* 



366 



CALABAR BEAN. 



lowed by a secondary depres- 
sion. 

The contraction of the iris 
noted above, which takes 
place equally on local or in- 
ternal administration, is con- 
sidered due to paralysis of 
the peripheral vaso - motor 
nerve fibres, and to stimula- 
tion of the terminal filaments 
of the third nerve. 

II. Circulating Appa- 
ratus — Under small doses of 
Calabar bean, the heart's 
action becomes slower and 
stronger, and the arterial 
tension is notably increased; 
but when the system is 
brought more fully under 
the poisonous influence of 
the drug, the cardiac pulsa- 
tions become feeble and 
irregular, and finally cease. 
These results are believed 
to be due to stimulation and 
subsequent exhaustion of the 
peripheral cardiac filaments 
of the vagi, and the primary 
contraction and subsequent 
relaxation of the arteries are 
explained in the same way. 

III. Respiration and Tem- 
perature The breathing 

usually becomes slow and 
irregular, and the tempera- 
ture falls a little. 

IV. Secreting Organs. — 
Calabar bean tends to cause 
vomiting, with violent and 
painful contraction of the 
stomach and increased peri- 
staltic movement of the in- 
testines. 



IV. [On account of its 
effects upon the secretions of 
the alimentary tract, it is 
used with advantage in con- 
stipation.] 



CALABAR BEAN. oG7 

Increase in the salivary 
and cutaneous secretion has 
also been observed. 

Poisonous Action. Cautions. Mode of 
Administration. 

Calabar bean in small doses destroys life by paralyzing 
the respiratory centre and causing suffocation, but in larger 
quantity it proves more speedily fatal by cardiac syncope. 

Caution is of course necessary in dealing with so poison- 
ous a substance as this. It is seldom used internally, for in 
tetanus the functions of the stomach are suspended in great 
measure, and drugs are probably only very partially absorbed. 
Subcutaneous injection is therefore our best method, and 
we use a solution of the extract (from |- to ^ gr. or .01 to .02 
Gm.), neutralizing its irritating acidity by the addition of a 
little soda. 

The alkaloid eserin, said to be the active principle, is 
unstable and difficult to extract, and is therefore practically 
useless. [The sulphate of eserin is ten times the strength 
of the extract, but is more liable to decomposition. 

The following formula was used successfully in a case of 
traumatic tetanus by Dr. Laycock : — * 



I£. Eserin. sulphat. 


gr- h 


03 


Gllycerinae, 


f<5ij 


8 


Syrup, auraritii corticis, 


f"5xiv 


56 


Aquae, 


fjij 


64 


Dose, one drachm. 







M. 

The glycerine being added to prevent changes in the eser- 
ine. In the case referred to (9 years of age) a teaspoonful 
was given at first every hour, afterwards it was reduced as 
the symptoms ameliorated. During seven days of treatment 
the boy took three grains (.20 Gm.) in all, without any toxic 
effects of the remedy being noticed, other than its influence 
in controlling the disease. 

The tincture of physostigma (not officinal) is recom- 
mended as a useful preparation of this remedy, which is not 
so well known as it deserves to be.] 

[ ] New Orleans Med. and Surg. Journ., March, 1882.] 



868 PIMENTO — BLACK PEPPER. 

[Pilulse. 

The officinal Pills are — 

Pilulae Aloes Pilulse Ferri Iodidi 

" " et Assafoetidse " Gralbani Compositse 

" " et Mastiches " Hydrargyri 

" " et Myrrh se " Opii 

" Antimonii Composite " Quinise Sulpliatis 

" Assafoetidse " Rhei 

" Catharticse Compositse " " Composite 

; ' Copaiba? " Scillse Compositse 

" Ferri Compositse 

Two Pill-masses are officinal : Pilula Ferri Carbonatis 
and Pilula Saponis Composita.] 



XPIMENTA— PIMENTO. 

Syn. Allspice. 
The unripe berries of Eugenia Pimenla (De Candolle), U. S. 

Officinal Preparation. 

Oleum Pimentae. Dose, gtt. iij-vj (.20 to .40 Gm.). 

Pimento is a warm, aromatic stimulant, but is more used 
as a condiment than as a medicine. As a carminative, the 
dose is from 10 to 40 grains (.65 to 2.65 Gm.).] 



PIPER— BLACK PEPPER. 

[The unripe berries of Piper nigrum, U. S. 

Officinal Preparation. 

Oleo-resina Piperis. Dose, try (.06 Gm.).] 

Pepper is an acrid stimulant, acting more especially on 
mucous membranes, and hence, as a condiment, it is sup- 
posed to excite the secretion of the gastric juice. In former 
years it also acquired some reputation as a remedy for haemor- 
rhoids. [Piperin, not officinal, is sometimes added to anti- 
periodic pills, and it is certainly active, although it has been 
stated that it owes its effects to an impurity, the active oil 
of pepper.] 



BURGUNDY PITCH — TAR. 3G9 

PIX BURGUNDICA— BURGUNDY PITCH. 

\_A prepared resinous exudation from Abies excelsa (Lamarck's 
Ency. Method.), U.S. 

Officinal Preparations. 

Emplastrum Pieis Burgundicae. 
Emplastrum Pieis cum Cantharide. 

Enters into Emplastrum Antimonii, Emp. Ferri, Emp. 
Galbani Compositum, Emplastrum Opii.j 

Pitch is used externally in the form of plaster. 



[PIX CANADENSIS— CANADA PITCH. 

Syn. Hemlock. 

The prepared resinous exudation from Abies Canadensis (Michaux, 
N. Am. Silva), U. S. 

Officinal Preparation. 

Emplastrum Pieis Canadensis. 

Used only in the form of the plaster. The oil of the 
Abies, or Pinus Canadensis, or Hemlock Spruce (oil of 
spruce, oil of hemlock), has been given to produce abortion. 
A fluid extract of the bark (Ext. Pinus Canadensis fluid.), 
not officinal, is largely used as an astringent for gargles, 
vaginal douches, etc.] 



PIX LIQUIDA— TAR. 

[ The impure turpentine from the ivood of Pinus palustris, and of other 
sjiecies of Pinus, prepared by burning, U. S. 

Officinal Preparations, U. S. 

Glyeeritum Pieis Liquid© (n^ xxx, in f^j). Dose, 
f5.i-iv (4. to 16. Gm.). 

Infusum Pieis Liquid© (Tar, 20 per cent.). Dose, 
f^ss-j (16. to '32. Gm.). Tar water. A wine or beer of tar 
has also been made by using beer in place of the water. It 
is o-iven in the same doses. 

Unguentum Pieis Liquid© (Tar, 50 per cent.).] 



370 



LEAD. 



External Actions. 



Physiological. 

Tar acts as a stimulant to 
the skin, and is apt to pro- 
duce an irritable papular 
eruption. It is rapidly ab- 
sorbed, and if allowed to re- 
main in contact with the 
surface of the body, or if 
applied over an extensive 
cutaneous area, feverish 
symptoms ensue, with an 
abundant discharge of black- 
ish urine, smelling strongly 
of tar. 



Therapeutical. 

Tar is an excellent appli- 
cation in cases of chronic 
scaly skin diseases, as psori- 
asis. 

To lessen the risk of ex- 
citing an undue amount of 
irritation, it is well to wash 
the skin perfectly clean be- 
fore renewing the applica- 
tion, and it is important to 
rub in the ointment thor- 
oughly until it nearly disap- 
pears. 



Internal Actions. 



Tar seems to have a stimu- 
lating action on mucous mem- 
branes when taken internally. 
[Tar contains a certain pro- 
portion of creasote, upon 
which some of its therapeutic 
effects depend.] 



The vapor of tar used to 
be a remedy of some repu- 
tation in chronic bronchitis, 
and recently Prof. Ringer has 
recommended two-grain pills, 
three times a day, as a most 
efficient remedy in winter- 
cough. The internal use of 
tar has also been praised by 
Dr. McCall Anderson in 
chronic skin diseases. [The 
syrup of tar (3j in f^iv) 
is not officinal, but may be 
given in advanced bronchitis, 
in half-ounce doses. The 
infusion is stimulant and diu- 
retic] 



PLUMBUM— LEAD. 

[Offictnal Preparations, U. S. 

Plumbi Oxidum (Litharge). Used in making Emplas- 
trum Plumbi (Diachylon or Lead-plaster), which en- 



LEAD. d/1 

ters into Emplastrum Assafbetidae, Emplastrum Ferri, 
Emplastrum Galbani Compositum, Emplastrum Hy- 
drargyri, Emplastrum Opii, Emplastrum Resinse (Ad- 
hesive plaster), Emplastrum Aconiti, Emplastrum Ar- 
nica?, Emplastrum Belladonna?, Emplastrum Saponis, 
Ceratum Saponis. 

Liquor Plumbi Subaeetatis (Goulard's extract). 
Liq. Plumbi Subaeetatis Dilutus (lead-water). 
Ceratum Plumbi Subaeetatis (Goulard's cerate). 
Linimentum Plumbi Subaeetatis. 

Plumbi Acetas (Sugar of lead). Dose, gr. ij-v (.12 

to .30 Gm.). 
Suppositoria Plumbi (each gr. iij). 
Suppositoria Plumbi et Opii (each gr. iij, and Ext. Opii 

gr. ss). 

Plumbi Carbonas. 

Unguentum Plumbi Carbonatis (5j in 3J). 

Plumbi Nitras (used as a disinfectant — Ledoyen's solu- 
tion). 

Plumbi Iodidum. 

Unguentum Plumbi Iodidi.] 

Poisonous Effects. 

The first sign of chronic lead-poisoning is a bluish line 
running along the free margin of the gums composed of mi- 
nute dots, and depending on the actual deposition of lead in 
the mucous membrane. To this succeed colic, wrist-drop, 
and the other symptoms mentioned above, the post-mortem 
disclosing chronic catarrh of the stomach and intestines, 
with the deposition of the metal in the bones, liver, kidney, 
brain, nervous and muscular fibres. 

Chronic lead-poisoning has occasionally resulted from adul- 
terated cider or from water, and indeed in a variety of ways, 
but it is most common in painters, who are brought much in 
contact with the carbonate in the practice of their business. 

Antidotes and Treatment. 

[Sulphuric acid forms an insoluble compound with lead, 
and, therefore, the soluble sulphates (alum, Epsom salts) are 
chemical antidotes to lead-poisoning ; they often are given 



372 



LEAD. 



combined with sulphate of morphia to relieve pain and relax 
spasm.] Salt is said to be useful, because the metal is natu- 
rally eliminated from the kidneys as a chloride. 

In poisoning by lead, we must give sulphate of magnesia, 
iodide of potassium, sulphur baths, and remove its after- 
effects by galvanism of the paralyzed muscles; but it is stated 
that sulphuric-acid lemonade, and a liberal indulgence in 
fatty articles of diet, may act in some degree as prophy- 
lactics. 



Local Actions. 



Physiological. 



Therapeutical. 



The external action of lead 
is partly sedative and partly 
astringent. [All the prepara- 
tions of lead are used exter- 
nally, but the acetate appears 
to be the one best adapted 
for internal use.] 

Squire praises a glycerate 
of the subacetate of lead very 
highly in eczema. 



Lead, in the form of sub- 
acetate, is much used as lotion 
for erysipelas, acute eczema, 
and various ulcerative condi- 
tions. 

It forms a good collyrium 
in the more superficial inflam- 
mations of the eye ; but we 
must remember that its ten- 
dency to deposition may cause 
a permanent white patch in 
corneal ulcers. 

The powder of nitrate of 
lead has been shown to be a 
good application in onychia 
maligna. 

[An improved process for making Hebra's diachylon oint- 
ment for skin diseases, is given by Deringer (New Remedies, 
1880) as follows : Dissolve 200 Gm. of acetate of lead in one 
litre of distilled water, and 300 Gm. of white Castile soap 
in 1-^ litre of warm distilled water. Filter both solutions 
and mix them. The precipitate is washed with water, then 
freed as much as possible from moisture by kneading, and 
one part of it is melted with 1^- parts of best olive oil, on the 
warm bath. The mixture is then triturated in a mortar 
until it forms a fine white salve — (Proc. Am. Pharm. Assoc, 
1881, p. 63.).] 



LEAD. 



373 



Internal Action and Uses. 



1. Brain and Nervous 
System. — When lead is given 
in poisonous doses, a curious 
train of nervous symptoms 
show themselves, beginning 
with violent neuralgic pains 
and giddiness, and running 
on into delirium, with epilep- 
tiform convulsions, and subse- 
quent melancholia. Sclero- 
sis of the areolar tissue, with 
diminution of the nervous ele- 
ments, has been found in cer- 
tain of the sympathetic gan- 
glia, but more especially the 
eceliac and cervical ganglia, 
Atrophy of the optic nerve is 
an occasional, though rare, 
complication of lead-poison- 
ing. 

2. Heart and Circulation. 
— During the action of lead, 
the heart becomes slow and 
the pulse smaller and harder, 
indicating a condition of con- 
traction and tension of the 
arterial system ; and this is 
by some supposed to be due 
to a primary effect on the 
sympathetic, whilst others 
hold that lead has a direct 
influence over unstriped mus- 
cular fibre, and most power- 
fully over that which encir- 
cles the arteries. Lead tends 
to produce pallor by destroy- 
ing the red blood-corpuscles. 

3. Intestinal Tract. — A 
prominent symptom of chro- 
nic lead-poisoning is obsti- 

32 



2. This contractile influ- 
ence of lead over the smaller 
vessels explains its action in 
interned hemorrhage, as we 
know that hesmoptysis. more 
especially, may be very suc- 
cessfully treated by acetate of 
lead in doses of from J gr. to 
3 grs. (.03 to .20 Gin.). 



3. Acetate of lead is an 
excellent astringent in diar- 
rhoea, more especially that of 



374 



LEAD. 



nate constipation depending 
probably on contraction of 
the small intestine, and asso- 
ciated with violent colicky 
pain around the umbilicus. 
The appetite at the same 
time becomes bad, the tongue 
loaded, and nausea and even 
vomiting are observed. Gas- 
troenteritis is generally one 
of the symptoms of acute 
poisoning. 

4. Urinary System. — Lead 
has the curious property of 
obstructing the elimination 
of uric acid from the blood 
through the kidneys, and may 
thus cause gout in painters 
and others who are exposed 
to the effects of the metal. 

5. Muscular — Lead causes 
violent pains in the muscles, 
with a peculiar form of para- 
lysis affecting the extensors 
of the forearms, and causing 
the well-known wrist-drop; 
and post-mortem we find fatty 
degeneration of the muscular 
structures. 

The contracting power of 
lead over unstriped muscular 
fibre probably explains the 
tendency to abortion noted 
during its poisonous influ- 
ence. 



phthisis, and British [or spo- 
radic'] cholera. 

Dr. Thorowgood has ob- 
tained good results from lead 
in obstinate obstruction of the 
bowels. 



Mode of Elimination. 

Lead is thrown out of the system by the urine, skin, 
bowels, and lacteal glands. 



MAY APPLE. 375 

Mode of Administration, etc. 

If we wish to administer lead internally, we generally 
prescribe either the acetate or pil. plumbi cum opii [Br.] 
(1 gr. of opium in 8), dose, 4 to 8 grs. (.25 to .50 Gm.). 

Externally we find the liquor plumbi subacetatis dilutus 
the most convenient form. 



PODOPHYLLUM— MAY-APPLE. 

[The rhizome of Podophyllum pel tut um, U. S. 
Officinal Preparations, U. S. 

Extraetum Podophylli. Dose, gr. v-xv (.30 to 1. 
Gm.). 

Resina Podophylli (sometimes called pbdophylliri). 

Dose, gr. £-J (.007 to .015 Gm.).] 

Local Action. 

Podophyllin cannot penetrate the unbroken cuticle, but 
experiment has shown that it exerts its purgative influence 
when applied to a raw surface. 

Constitutional Actions. 

Physiological. Therapeutical. 

The only marked physio- Podophyllin is a valuable 

logical property of this drug remedy in jaundice and in 

is that of irritating the duo- the various forms of func- 

denum and causing a profuse tional liver affection. It 

flow of watery evacuations, may be used in simple chronic 

largely mixed with bile, constipation, in the eonstipa- 

Some controversy has taken tion of children attended with 

place as to whether podo- the painful and difficult eva- 

phyllin can be called a chola- cuation of hard, dry feces, 

gogue in virtue of any direct and in the opposite condition 

stimulation of the secreting of diarrhoea with pale and 

structures of the liver, ex- frothy motions, 

perimental evidence seeming In sick headache it also 

to show that it probably acted acts well, 

by contracting the gall- [Podophyllum is an effi- 

bladder, and thus favoring cient substitute for jalap, and 

the expulsion of its contents, may be used for all purposes 



376 POTASSIUM. 

and by exciting the duodenum for which the latter drug has 
to sweep away the bile ef- been recommended.] 
fused into it by the hepatic 
ducts. The more recent ex- 
periments of Rutherford and 
Vignal, however, have re- 
instated podophyllin in its 
old position as a true stimu- 
lant of the biliary secretion. 
The mistake made by Ben- 
nett, who denied its chola- 
gogue action, having arisen 
from the administration of 
too large doses, and the con- 
sequent antagonism of the 
intestinal irritation to the 
hepatic secretion. 

Cautions and Mode of Administration. 

"We must remember that podophyllin is an uncertain drug, 
acting well in some cases, \evy slightly in others, whilst in a 
third class it causes much discomfort and griping. It is ad- 
visable, therefore, always to begin with small doses, as ^ gr. 
or J gr., and to prescribe it in the form of a pill, combined 
with other ingredients which may restrain its irritating 
action. Thus : — 

I£. Resinse podophylli gr. ij ; or jl2 Gm. 

Extracti belladonnae gr. iij ; " |20 " 

Pil. colocyrithidis composite gr. xxxvj; " 2,30 " M. 

Fiant pilulse duodecim, quarum capiat imam omni nocte. 

Ringer recommends a very convenient way of prescribing 
podophyllin for children, by dissolving a grain in a drachm 
of rectified spirit, and giving 5 or 6 drops three or four times 
a day, on a lump of sugar [or it may be simply painted on a 
bun]. 



POTASSIUM— POTASSIUM. 

[Officinal Preparations, U. S. 

Potassa. Caustic Potassa. 

Liquor Potassse. Dose, n^x-xxx (.65 to 2. Gm.). 

Potassa cum Calee (equal parts) used as a caustic. 
Potassii Aeetas. Dose, gr. xx-3j (1.30 to 4. Gm.) 



potassium. da 

Potassii Bichromas (as an alterative). Dose, gr. I- 
(.01 Gm.). Rarely administered internally. 
(Used in preparing Sodii Valerianas.) 
Potassii Bitartras (Cream of Tartar). Dose, 3j- iv (4. 
to 16. Gm.). 
Antimonii et Potassii Tartras, Ferri et Potassii Tartras, 
Potassii et Sodii Tartras (Roclielle Salt), Potassii Tar- 
tras, Pulvis Jalapae Compositus. 
Potassii Bromidum. Dose, gr. xx-5j (1.30 to 4 Gm.). 
Potassii Carbonas Impura (Pearlash). 

Potassii Carbonas. Dose, gr. x-xxx (.65 to 2. Gm.). 
(Extractum Spigelian et Sennre Fluidum, Mistura Ferri 
Composita, Potassii Biearbonas, Potassii Sulphuretum, 
and in making Chloroformnm Puriticatum and Spiritus 
xEtheris Xitrosi.) 
Potassii Carbonas Pura. Dose, gr. x-xxx (.65 to 2. Gm."). 
(Used in making Potassium Bromide and Cyanide, and 
Mistura Potassii Citratis.) 
Potassii Biearbonas. Dose, gr. x— 3j (.65 to 4. Gm.). 
(Liquor Magnesii Citratis, Liquor Potassre, Liquor Po- 
tassii Arsenitis, Liquor Potassii Citratis, Mistura Po- 
tassii Citratis, Potassii Acetas, Potassii Carbonas Pura, 
Potassii Citras.) 
Potassii Chloras. Dose, gr. v-xx (.30 to 1.30 Gm.). 

Trochisci Potassii Chloratis. 
Potassii Citras. Dose, gr. x-xxx (.65 to 2. Gm.). 

Liquor Potassii Citratis. Dose, f^ss (16. Gin.). 
Potassii Cyanidum. Dose, gr. T ^ to T ^ (.005 Gm.). 
Potassii Ferrocyanidum. Dose, gr. x-xv (.65 to 1. 
Gm.). 
(Used in making Acidum Hydrocyanicum Dilutum, Ar- 
genti Cyanidum, Ferri Ferrocyanidum. Hydrargyri 
Cyanidum, and Potassii Cyanidum.) 

Potassii Hypophosphis. Dose, gr. x-xxx (.65 to 2. 
Gm.). 

Potassii Iodidum. Dose, gr. x-5j (.65 to 4. Gm.). 
( Ammonii Iodidum, Hydrargyri Iodidum Rubrum, Liquor 
Iodinii Compositus, Plumbi Iodidum, Tinctura Iodinii 
Composita, Unguentum Iodinii, Unguentum Iodinii 
Compositum, Unguentum Potassii Iodidi (5j to 3J).) 
32* . 



378 potassium. 

Potassii Nitras. Dose, gr. x-xv (.Qo to 1. Gra.). 
Potassii Permanganas. Dose, gr. j-v (.06 to .30 Gm.). 

Liquor Potassii Permanganatis (gr. iv to f^j). 
Potassii Sulphas. Dose, gr. xx-3iv (1.30 to 16. Gm.). 

Pulvis Ipecacuanhas Compositus. (Dover's powder.) 
Potassii Sulphis. Dose. gr. xv-5j (1. to 4. Gm.). 
Potassii Sulphuretum. Dose, gr. ij-v (.12 to .30 Gm.). 
Potassii et Sodii Tartras (Rochelle Salt). Dose, ^ss-j 

(16. to 32. Gm.). 

Potassii Tartras. Dose, 5J-oj (4. to 32. Gm.). 

Poisoning. 

Caustic potassa is a corrosive mineral poison. The 
symptoms produced by it are an acrid, caustic, urinous taste 
in the mouth, a sensation of burning heat in the throat, 
nausea, and sometimes vomiting of bloody matters. The 
surface becomes cold and clammy ; the pulse quick and feeble ; 
and there is often hypercatharsis, and violent colicky pains. 

Morbid Appearances. — Strong marks of inflammation in 
the alimentary canal, with softening, erosion of the mucous 
coat, and, in some cases, perforation of the- stomach. 

Tests. 

The alkaline reaction. It precipitates silver nitrate in the 
form of a dark-colored oxide. Carbonic acid water causes 
no precipitate. A concentrated solution, acidulated with 
muriatic acid, affords a deep-yellow precipitate with platinum 
bichloride. A solution of tartaric acid causes a white preci- 
pitate of cream ot tartar. 

Antidotes. 

Yinegar and the diluted vegetable acids ; to be followed 
by a free use of demulcents, or oleaginous mixtures.] 

Local Action. 

Physiological. Therapeutical. 

Caustic potash is a most Caustic potash, either in 
powerful escharotic, with- sticks or combined with lime 
drawing water from the tis- in the form of potassa cum 



POTASSIUM. 



379 



sues, and thus destroying 
them. It bus, however, the 
disadvantage of being very 
deliquescent, and this ten- 
dency to spread, beyond the 
part we wish to attack, has 
led to its practical abandon- 
ment as a local application. 



The permanganate of pot- 
ash (Condy's fluid) oxidizes 
and destroys many organic 
substances. 



calce, was formerly used in 
the treatment of various 
forms of ulceration, and for 
the production of issues, 
which barbarous relics of 
antiquity are now fortunate- 
ly discarded from practice. 
Liquor potassse has been re- 
commended to soften the 
great toe-nail and facilitate 
its removal when ingrowing ; 
and the bicarbonate of pot- 
ash forms a good lotion in 
acute eczema, as an injection 
in leucorrhcea, and as an ap- 
plication to rheumatic joints. 
It is therefore antiseptic, 
and a good application to un- 
healthy ulceration. 



Internal Actions and Uses. 



Physiological. 

1. Brain and Nervous Sys- 
tem Potash salts, and more 

especially the nitrate, when 
given in large doses, exert a 
paralyzing action on the spi- 
nal cord, producing great 
muscular weakness and finally 
abolition of reflex sensibility. 

2. Heart and Circulation. 
— Moderate doses of the ni- 
trate raise the arterial tension 
and slow the heart's action, 
and if the drug is further 
pushed, the pulsations be- 
come weaker, still slower, 
and finally irregular, before 
the total arrest of movement 
supervenes. It prevents the 
coagulation of the fibrine, and 



Therapeutical. 



380 



POTASSIUM. 



the red corpuscles are re- 
strained in their functions of 
oxygenation. Gubler de- 
scribes a sort of chronic poi- 
soning in those who eat ham 
treated by pot. nit. to heighten 
its color, and consisting of 
weakness, palpitation, anae- 
mia, and a kind of scurvy. 

Potash salts cause the 
blood, and secondarily, the 
urine, to become alkaline, 
and any excess of uric acid 
may thus become neutralized. 



3. Intestinal Tract. — Chlo- 
rate of potash moderates ex- 
cessive action of the salivary 
glands, and assists the heal- 
ing of ulceration about the 
gums, mouth, and throat. 
The salts of potash generally 
neutralize free acid in the 
stomach and intestines, and 
the nitrate in full doses may 
cause death by gastro-ente- 
ritis. Most of the potash 
salts are slightly purgative, 
but only the acid tartrate has 
any very decided action of 
this kind, causing as it does 



2. This has been supposed 
to explain the beneficial ac- 
tion of potash in acute rheu- 
matism, which is held to de- 
pend on an excess of uric 
acid. Much controversy has 
taken place with reference to 
the alkaline treatment of this 
disease, but I am decidedly 
of opinion that if large doses 
of bicarbonate of potash do 
not shorten its duration, they 
relieve symptoms, and lessen 
the tendency to cardiac com- 
plications. Potash acts well 
also in gout and chronic rheu- 
matism by forming a soluble 
salt with uric acid. 

3. Chlorate of potash, in 
doses of from 5 to 20 grains, 
is an admirable remedy in 
mercurial salivation, in va- 
rious aphthous conditions, 
and in sore throat, whether 
produced by [diphtheritic 
croup~\, scarlet fever, or ordi- 
nary tonsillar inflammation, 
aud a wash or gargle may 
well be combined with its 
internal administration. 

In doses of from 120 to 
300 grains, cream of tartar 
is a good purgative, but is 
principally used in combina- 



POTASSIUM. 



381 



the abstraction of a large 
quantity of watery fluid, with- 
out, however, stimulating the 
peristaltic movement of the 
intestines. The sulphate is 
also aperient in its action. 

4. On Secreting Organs — 
It will be remembered that, 
in speaking of acids, we re- 
ferred to a law which has 
been more especially devel- 
oped by Ringer, and which 
explains their power of check- 
ing acid secretions. Alkalies 
have precisely the opposite 
effect, arresting the activity 
of glands furnishing alkaline 
fluids, whilst they directly 
stimulate those whose secre- 
tion partakes of the opposite 
character. 



Kidneys Most of the 

salts of potash, but more es- 
pecially the acetate, nitrate, 
citrate, and acid tartrate, are 
diuretic, and the acetate, bi- 
carbonate, and citrate, being 
converted into carbonate, 
speedily render the urine al- 
kaline. Elaborate experi- 
ments have been made on the 
more precise alterations ef- 
fected in the urine by the 
salts of potash. Prof. Parkes 
tells us that liquor potassae 
increases the destructive 
metamorphosis of the nitro- 
genous tissues, and their 
elimination as urea, as well 
as that of the sulphur in the 
form of sulphates. The ace- 



tion with jalap, which, by 
stimulating the muscular 
movements of the small in- 
testines, prevents the proba- 
ble reabsorption of the watery 
fluid. 

4. We can therefore read- 
ily explain, on physiological 
principles, why alkalies are 
so useful in hepatic conges- 
tion, why they may also stim- 
ulate the pancreatic secre- 
tion, and why their action is 
so beneficial in cases of dys- 
pepsia depending on deficient 
supplies of gastric juice. On 
these principles, also, we may 
readily understand the very 
striking power possessed by 
a weak solution of potash in 
arresting the alkaline secre- 
tion so freely poured out by 
the skin in acute eczema. 

Potash salts are therefore 
good diuretics in heart dis- 
ease, chronic kidney affec- 
tions, and various drojjsical 
accumulations ; and their ac- 
tion is much more marked 
under these conditions than 
when administered to healthy 
subjects, since we have seen 
that the acetate, which is 
perhaps the most active of 
the diuretic group, may even 
check the elimination . of 
water from the kidneys dur- 
ing health. Dr. Roberts, of 
Manchester, has proposed to 
dissolve uric acid calculi by 
keeping the urine alkaline 
for months with citrate of 
potash. 



382 POTASSIUM. 

tate has been shown to di- 
minish the water, urea, and 
earthy salts ; whereas the 
citrate, according to Dr. Nun- 
neley, increases the water, 
but diminishes the urea and 
solids. 

Potash may be used under other conditions. Thus in 
asthma the inhalation of the fumes from burnt blotting- 
paper soaked in a strong solution of nitrate of potash is often 
effectual ; chlorate of potash is a useful ingredient in a cough 
linctus ; the citrate is an agreeable febrifuge, and is valuable 
in many of the feverish and dyspeptic affections of children. 

Duckworth {Practitioner, May, 1878) highly praises 
nitre paper in bronchitis, and says that a little Friar's bal- 
sam painted over the paper is an improvement. This treat- 
ment in asthma often fails from the fumes not being used 
freely enough. 

Scurvy is held by some to be dependent on a deficiency 
of potash salts in the blood. 

Poisonous Action. 

Partly from depression of the heart and partly from in- 
flammation of stomach and intestines. 

Mode of Elimination. 

The potash salts, having a high diffusive power, pass 
readily into the blood, and are given out by the urine, in 
which the nitrate, chlorate, and sulphate reappear unchanged. 



M 



~fy. Liquoris potassse 


f 5U ; 


or 


8 


Gm. 


Tincturae calumbce 


f 3ij ; 


" 


81 " 


Infusi calnmbae 


fgvj; 


(< 


102| " 


Fiat mist, f §j ter die. 








mtacid mixture. 








~fy. Potassii carbonatis 


3i; 


or 


4 


Gm 


Potassii acetatis 


gr. xv ; 


1 1 


1 


i i 


Potassii nitratis 


gr. x; 


i i 




65 " 


Aquse 


f^ij; 


a 


64 


n 



M. 
Fiat haustus quartis horis sumend. 

This constitutes the " full alkaline" treatment recom- 
mended by Dickinson for acute rheumatism, and may be 
prescribed in effervescence. 



BICHROMATE OF POTASSIUM. 



383 



Ify.. Potassii chloratis 


3ij; 


or 


8 


Syrupi limonis 


m ; 


n. 


32 


Aquae 


fliij; 


u 


96 



Gm. 

c< 

M. 

Dose, according to the aire of the child : if under two 
years f3j> from two to ten f5ijj over ten f^ss, given every 
three hours, or every half hour in urgent cases. Recom- 
mended as almost specific in diphtheritic croup by Dr. T. 
M. Drysdale.] 

4 dm. 
192[ " 



*J 



P^. Potassii chloratis 

Aquae 
S. f §j ter die. 

In ulcerated mouth or gums, or mercurial salivation. 

or 



B/. Potassii bicarbonatis £ss ; 

Aquae Oj ; 

A good lotion in acute eczema. 

P^. Potassii acetatis ^iss ; 

Aceti scillre f 7,\v ; 

Decocti scoparii [Br.] ad f^vj ; 
Fiat mist. Dose, f §j quartis lioris. 

Diuretic mixture. 



2 Gm. 

500 ■• 



16 
192 



fy. Spiritus retlieris nitrosi 
Potassii nitratis 
Decocti scoparii [Br.] 

Fiat mist. Dose, f §j ter die 


gr. xx 
fgir; 


Diuretic. 




^. Potassii bitartratis 
Succi scoparii [Br.] 
Aquae 

Dose, f §j ter die. 


5iij ; 

3v.i ; 


Diuretic. 




$. Potassii chloratis gr. xl ; 
Glycerine f,l ss > 
Morphias muriat. gr. jss 

Syrupii ad f §iv ; 



Gm. 



1,30 

128 



12 Gm. 
24 
192 



2'60 Gm. 
16 
ilO 
128 



M. 



M. 



M. 



M. 



M. 



M. 



S. f 3j prout res poscit. 

Dr. Douglas Powell's linctus for the chronic throat irrita- 
tion of consumptive patients. 



[Potassii biehromas. 

Potassium bichromate, in powder or strong solution, is a 
good escharotic and antiseptic application to warts, and ve- 



384 



BROMIDE OF POTASSIUM. 



nereal excrescences. It has been used internally in secondary 
syphilis, as an alterative, given in pill-form with some 
bitter extract. Occasionally it produces salivation. It acts 
as an emetic in doses of j gr. In large amounts it is an acrid 
mineral poison, and causes a burning heat in the mouth, 
throat, and stomach ; excessive and painful vomiting of 
bloody mucus ; convulsions and palsy and death. 

Morbid Appearances. — Softening and abrasion of the 
mucous coat of the stomach and intestines. 

Tests — In substance, by its orange-red color. In solu- 
tion, by affording a rich red precipitate with nitrate of silver, 
a bright yellow with acetate of lead, a dingy green color and 
whitish turbidity with sulphuretted hydrogen. 

Treatment. — The use of the potassium or sodium carbon- 
ates to neutralize the excess of chromic acid, followed by 
the administration of emetics. It would also be advisable 
to employ chalk or magnesia, in connection with milk, or 
the albumen of eggs.] 



Potassii Bromidum. 

(Bromide of Potassium is not used externally.) 



Physiological Action. 

1. On Nervous Function. 
— Long continuance in the use 
of potassium bromide tends 
to cause a sense of fatigue 
and general muscular pros- 
tration, with giddiness and 
staggering. 

Brain. — The functions of 
the brain are lessened, and 
sleep results. [Observation 
has shown that the bromides 
actually reduce the amount 
of blood in the brain.] 

Spinal Cord It has been 

proved by experiments on 
animals that the reflex irrita- 
bility of the cord is lessened, 
as indicated by the ana3sthe- 



Therapeutical Action. 

1. Potassium bromide has 
gained great repute within 
the last few years in the 
treatment of a large series of 
convulsive and spasmodic af- 
fections, and most especially 
in epilepsy, it being now tho- 
roughly established that if we 
get our case sufficiently early 
we may absolutely cure it, 
and even if it is too confirmed 
for this result we may keep 
it in check. The cases most 
under the influence of the 
drug are those known as the 
haut mat, where violent strug- 
gling is followed by comatose 
sleep ; on the other hand, in 



BROMIDE OF POTASSIUM. 



385 



tic effect which is produced 
on the palate. 

It has also been observed 
that the power of voluntary 
movement persists after the 
abolition of reflex function, 
proving that the influence of 
the drug is exerted probably 
either upon the afferent nerves 
or upon those portions of the 
cord which transmit the im- 
pulse from these nerves to the 
cells presiding immediately 
over motion. 

The recent experiments of 
Ringer and Morshead show 
that, in the frog, the reflex 
functions of the cord are 
at first abolished, voluntary 
movement being unimpaired, 
but that later on, the volun- 
tary functions also become pa- 
ralyzed. They point out that 
these symptoms are entirely 
due to the potash, as potassium 
iodide and potassium chloride 
cause the same symptoms, 
which are never observed after 
the administration of the bro- 
mide of sodium. Potassic bro- 
mide also lessens the irrita- 
bility of the sensory nerves. 

Sympathetic System. — Po- 
tassium bromide is supposed 
to have a sedative influence 
over the sympathetic system 
of nerves ; but on this point 
the evidence is very contra- 
dictory. 



33 



the petit mal, where the at- 
tack is indicated merely by 
passing unconsciousness, or 
when the seizures occur prin- 
cipally at night, the remedy 
will frequently disappoint us. 

A New York committee of 
the Pathological Society, un- 
der the presidency of Dr. E. 
Seguin, have recently re- 
ported on a combination of po- 
tassium bromide with chloral 
in epilepsy, and praised its 
efficiency in arresting the pa- 
roxysm, avoiding remission, 
and keeping up the general 
condition of the patient. 

When the. remedy is act- 
ing well in epileptics, we will 
always readily detect a de- 
cided suppression of reflex 
sensibility (nausea) at the 
back of tongue and fauces. 

Potassium bromide is be- 
lieved to act in epilepsy by 
relieving the spasmodic con- 
traction of vessels supplying 
a special vascular brain area 
which is thus deranged in 
function. 

It is also of great benefit in 
the var : ous convulsive sei- 
zures oi children in laryngis- 
mus stridulus, night terrors, 
and also in those spasmodic 
symptoms which depend on 
meningitis or organic brain 
disease. 

It is of service in incon- 
tinence of urine, pertussis, 
crump of lower limbs, chorea, 
in delirium tremens, and in 



386 



BROMIDE OF POTASSIUM. 



2. Effects on Circulation. 
— No special action on the 
heart has been observed save 
some slight lowering of its 
action. The smaller arteries 
are believed to be contracted, 
the pulse becoming smaller ; 
and we may thus explain the 
hypnotic action of the drug, 
the brain being rendered ane- 
mic as in physiological sleep. 



3. Its influence on diges- 
tion is not marked ; for al- 
though it sometimes seems to 
lessen the appetite, this is not 
a constant result. 

4. The effects on the uri- 
nary secretion have not been 
thoroughly made out. 

5. Bromide of potassium 
has an undoubted influence 
over the generative organs, 
lowering their excitability, 
and even, in large doses, sus- 
pending their activity. 



many of those forms of men- 
tal depression, nervous head- 
ache, and vague sensations, 
indicating nervous disturb- 
ance, which are so distressing 
to some women about the 
change of life. 

It is said to be a good 
remedy in sea-sickness, from 
the sedative effect on the 
centre concerned in the reflex 
act of vomiting. 

2. Bromide of potassium 
is an excellent narcotic, and 
causes refreshing sleep, more 
especially in cases of worry, 
mental anxiety, or overwork, 
a full dose being given at bed- 
time ; and in acute mania its 
use in combination with chlo- 
ral is highly praised by Clous- 
ton. It is said to heighten 
the action of opium, and less- 
en the occasional unpleasant 
symptoms of nausea, faint- 
ness, and giddiness. It has 
been found useful in dys- 
pepsia. 



4. It has been much prais- 
ed by Begbie in diabetes. 

5. It is useful in priapism, 
and in those forms of menor- 
rhagia which depend on ova- 
rian irritability. 



BROMIDE OF POTASSIUM. 387 

Potassium bromide is eliminated from the system by the 
urine, breath, sweat, and milk (a case being recorded in 
which the child of a suckling mother taking the salt, became 
covered with acne). Some authorities think infants specially 
susceptible to its action. 

Disadvantages and Contra-indications. 

We have already noted the peculiar nervous symptoms 
occasionally caused by the bromides — giddiness, general mus- 
cular fatigue, even amounting to actual staggering in some 
cases. But in addition to this an unpleasant eruption of 
acne often breaks out on the face, and may arise from a very 
small dose. If, in spite of this, the remedy is persisted in, 
the whole body may eventually be covered with large and 
unsightly blotches, and boils, even rupial ulcers, have been 
observed. 

To prevent the bromide rash, we are advised to add a little 
liq. arsenicalis [Br.] to each dose, and we may remove the 
spots by the following lotion — 

R_. Sulphuris praecip. 

Spt. campliorse 

Aq. calcis ad §iij ; 96 " M. 

Ft. lotio. 
Apply morning and evening. 

Dose and Mode of Administration. 

The dose for epilepsy ranges from 10 to 60 grains, it being 
necessary to increase the quantity gradually, and continue 
its use for long periods, even years, occasionally leaving it 
off for a week or so, after which it seems to regain some of 
its lost effect. 

Dose as a hypnotic gr. xx ad xxx. Tn other cases about 
gr. xx as an average. Children appear to be very suscept- 
ible to its use, acne being readily produced in them by mode- 
rate doses. As its taste is rather nauseous, we must disguise 
it thus — 

R. Potassii bromidi gr. xxx 

Syrupi aurantii f £j ; 

Aquse aurantii lloruni q. s. ad f j|ij ; " 64 " M. 

Fiat haustus hor4 sonini sumendus. 
fy. Pot. bromidi §j ; 

Chloral hydratis S§ss : 

A qua? 3 v iij 

Dose, 3i thrice a day. 
Or, give it simply in water. 



siij ; 


or 


12 Gin 


&i ; 


t< 


4 " 


ad §iij ; 


it 


96 " 



2 Gm. 

4 " 
64 " 


32 Gra. 

16 " 

256 " 



388 



IODIDE OF POTASSIUM. 



[A brominized solution of bromide of potassium has been 
recommended for laryngeal diphtheria or pseudo-membranous 
croup — 

5vj ; or 120 Gm. 



120 

4 



R. Decocti al these .^ii 

Potassii bromidii 5.1 

Bromini n\x ; 

Syrupi simplicis fgviiss ; " 30 

Dose, f% every hour during urgent symptoms. 



30 



M. 



For children under one year the quantity of bromine in 
the mixture should be reduced to 0.10 Gin.., and for those 
from 1 to 4 years old to .20 Gm. 1 ] 

Potassii Iodidum — Iodide of Potassium. 
Constitutional Action. 



Physiological. 



1. On Bi 



id Ni 



System. — No special action 
on the nervous system has 
been observed, unless we hold 
that the uncomfortable sen- 
sations of misery and depres- 
sion occasionally following its 
use, may be thus explained. 



2. The effects of iodine on 
the circulation have never 
been properly estimated, but 
some observers say that it 
tends to contract the vessels 
and cause increased rapidity 
of the heart's action. Potas- 
sic iodide has very swift diffu- 
sive power, entering the blood 
very rapidly, being given off 
within ten minutes after in- 
gestion. 



Therapeutical. 

1. Iodide of potassium is 
of great service in many 
brain-diseases, and most es- 
pecially those in connection 
with tertiary syphilis, where 
gummata, and other forms of 
tumor, cause those excruciat- 
ing pains and varying nerv- 
ous phenomena which have 
been so ably described by 
Drs. Broadbent and others. 

2. Potassium iodide has 
been used with great benefit 
by Drs. Balfour, Da Costa and 
others in aortic aneurism, sev- 
eral successful cases having 
been reported. It is difficult 
to explain the rationale of its 
action, but it is essential that 
large doses (twenty grains) 
be prescribed, to be repeated 
several times daily, and con- 
tinued regularly for a year or 
more. 



1 Redenbacher-JErtzliches Intelligensblatt, January 7, 1879. The 
Practitioner, vol. xxii. p. 208. 



IODIDE OF POTASSIUM. 



389 



3. On respiration and tem- 
perature no effects have been 
noted. 

4. Effects on secretion. 

a. Intestinal. — Nothing spe- 
cial save occasional loss 
of appetite and disor- 
dered digestion. 

j3. Urinary Potassium io- 
dide has some diuretic 
action, more especially 
in connection with other 
drugs. 

y. The salivary secretion is 
often markedly increas- 
ed, true salivation being 
sometimes produced. 

8. It is also believed that the 
iodide of potassium has 
some special action on 
glandular tissues in gen- 



j3. Potassium iodide is oc- 
casionally used to heighten 
the diuretic action of other 
drugs. 



absorptive powers, and 
even exciting them to 
absorb themselves ; and 
in support of this last 
proposition it has been 
stated that, under its use, 
the mammas and testi- 
cles have been observed 
to waste and disappear. 
This conclusion has pro- 
bably been arrived at, 
however, by confusing 
the post with the prop- 
ter hoc, and it is proba- 
ble that the remedy does 
not so much actually 
stimulate the absorbents 
as reduce effused lymph 
to a condition more fa- 
vorable for elimination. 

33* 



6. The iodide of potassium 
is often given to facilitate and 
hasten the absorption of in- 
flammatory lymph in the later 
stages of pleurisy, pneumo- 
nia, pericarditis, etc. 



390 



IODIDE OF POTASSIUM, 



5. It also has the power of 
removing various metallic 
substances from the tissues, 
— mercury and lead, for in- 
stance, being occasionally de- 
posited in the form of an in- 
soluble albuminate, and re- 
leased from this condition by 
the action of the dru£. 



6. Finally, this salt has an 
irritating action on mucous 
membranes, causing redness, 
tinglinar, and free secretion, 

O o 7 

resembling much an ordi- 
nary catarrh, and also thin- 
ning and liquefying tena- 
cious, morbid, mucoid secre- 
tions. 



7. There are other import- 
ant uses of potassium iodide 
which cannot be arranged 
under the preceding catego- 
ries, and which must there- 
fore be called specific. These 
are its influence over syphi- 
lis, gout, chronic rheumatism, 
and simple periostitis. 



5. In cases of chronic 
lead-poisoning, so often met 
in house-painters, or where we 
wish to remove mercury from 
the system, we generally pre- 
scribe potassium iodide, and 
in the latter case we must not 
be surprised if our patient is 
suddenly seized with profuse 
salivation. This is explained 
by the released mercury find- 
ing its way back into the cir- 
culation, and exerting its 
usual influence on the salivary 
glands. 

6. Potassium iodide is often 
prescribed in cases of bron- 
chitis where the expectoration 
is thick, tenacious, and diffi- 
cult of expulsion, and it here 
acts well by thinning the 
sputa. [In chronic bron- 
chial disorders, liydriodic acid 
(page 310) affords a conven- 
ient method of administering 
iodine, especially to children.] 

7. In cases of tertiary 
syphilis, this salt often acts 
like a charm. In the pri- 
mary and secondary forms, 
it is of little or no use, but 
when the deeper tissues begin 
to be affected, and when we 
meet with deep rupial or 
other ulcerations of the skin, 
ulcers in the throat, perios- 
titis, and head symptoms, we 
may then prescribe iodide 
with the certain expectation 
of relief. In chronic gout it 
is also of service, and in chro- 
nic rheumatism, more espe- 
cially in those cases where 



IODIDE OF POTASSIUM. 391 

we meet with tenderness to 
pressure and nocturnal in- 
crease of pain. In simple 
periostitis of the skull, ster- 
num, or tibia, which often 
results from exposure to cold, 
iodide of potassium has an 
almost magical effect, and 
Avill often bring about a cure 
after two or three days' 
treatment. 

Potassium iodide is eliminated from the body by the urine, 
saliva, tears, milk, etc. ; it can be detected in the urine in 
ten minutes after being swallowed, and it is rapidly given 
out, so that the whole may be recovered from the various 
secretions. 

Disadvantages and Coxtra-ixdicatioxs. 

As regards its disadvantages and contra-indications, we 
must remember the possible occurrence of iodism, to which 
unpleasant symptoms some persons are much more susceptible 
than others. These consist, in the first place, of irritation 
about the mucous membranes, running at the eyes and nose, 
sneezing, frontal headache, swelling of the eyes, salivation, 
and the following variety of eruptions, all of which are more 
likely to occur in patients suffering from kidney disease: 1. 
A rash resembling urticaria. 2. An eruption which proba- 
bly, according to its various stages, may be either vesicular, 
papular, or pustular, closely resembling acne, or a more for- 
midable condition of things may arise from its development 
into bulla?, which, occasionally bursting, may form fungoid 
masses, varying in size from a pea to a shilling. This is 
again held to differ from hydroa, which, Mr. Hutchinson 
tells us, is almost invariably due to iodide of potassium. 3. 
Small miliary petechial spots on the front of the leg, below 
the knee, occurring from two to six days after the moderate 
use of the drug. 4. A general eruption of purpura. Dr. 
Stephen Mackenzie records a fatal case in a child of five 
months, following a single 2^-grain dose. 5. A tendency to 
erysipelas has been noted in patients taking potassium iodide. 
It is, however, fortunate for the credit of one of our most 
useful and widely used drugs that these eruptions are rarely 



392 IODIDE OF POTASSIUM. 

observed, the most common being a few acneiform pustules 
on the face, which careful microscopic observations have 
proved to be quite unconnected with the sweat glands, but 
to depend on plugging of the small vessels with coagula, 
followed by rupture and extrusion of their contents. 

Mr. James Lane (Harveian Lectures) gives the result of 
a large experience in the treatment of syphilis, and advises 
us to begin with small doses, 3 or 4 grains, and increasing 
until 15 or 30 grains (.20 to 2. Gm.), are reached. If it 
causes much irritation, we may substitute the iodide of so- 
dium. 

In some persons a good deal of depression and digestive 
derangement is caused. 

To Prevent Iodism. 

Some few years ago, Sir James Paget observed that the 
addition of spiritus ammonias aromat. to potassium iodide 
not only lessened the chances of iodism, but enabled us to 
limit ourselves to a smaller dose, and this has come very 
generally into use. 

Dose and Mode of Administration. 

[The iodide of potassium should be prescribed alone, or 
only in combination witli other preparations of iodine, or 
with corrosive sublimate. 1 

This salt may be given simply dissolved in water, or its 
taste may be well disguised by administering it in combina- 
tion with compound syrup of sarsaparilla, or compound infu- 
sion of gentian.] 

Potassium iodide as an antisyphilitic maybe given in doses 
of from 3 to 30 grains, or even 60, according to the judgment 
of prescribers, it being necessary in obstinate cases to push 
the drug very freely. 

[Dr. Taylor, at the meeting of the American Dermatolo- 
gical Association, said that patients would tolerate an ounce 
and a half daily and grow fat on it, the only physiological 
result being increased urination. He mentioned a case of 
nodes, where fourteen drachms daily were administered; 
nothing less would give the patient relief at night. He 
thought that in similar cases the addition of bromide of 

1 See page 44. 



PRUNES — WILD CHERRY. 393 

potassium, one drachm to seven of the iodide, would be of 
advantage. 

He also remarked that he had observed pains in the joints 
occasionally, even when small doses of iodide were being 
administered, which were considered as being due to the 
remedies employed. He offered a practical suggestion in 
reference to the prevention of these pains (which are diurnal 
and not nocturnal), which was that tincture of colchicum 
and tincture of hyoscyamus, combined with small doses of 
the iodide of potassium, would obviate them. Occasionally 
it is necessary to use camphorated oil, or some warming 
application externally. The joint trouble is sometimes poly- 
articular, sometimes non-articular.] 

Professor Syme, however, used to say that all good effects 
can be obtained by two or three grains, and in ordinary 
cases of syphilis or periostitis, rheumatism, etc., this would 
in his opinion, be found a sufficient dose, copious dilution 
aiding its effects. 

In aneurism we must give at least twenty grains, and in 
advanced syphilitic affections even larger doses are well 
borne. 

I£. Potassii iodidi gr. xl ; or 2 60 Grm. 

Spiritus auimonise arornatici f ^ss ; " 16 " 

Syrupi aurantii f §j ; "32 " 

Decocti sarsaparillse composite ad f^viij. " 256 " M. 

S. Capiat unciam imam ter in die. 



PRUNUM— PRUNES. 

[The dried fririt of Primus domestica, U. S. 

Enters into Confectio Sennas.] 
Prunes are slightly purgative. 



[PRUNUS VIRGINIANA— WILD CHERRY. 

The bark of Cerasas Serotina (De Candolle) U. S. 

Officinal Preparations, U. S. 

Extractum Pruni Virginian® Fluidum. Dose, 
f5j(4. 6m.). 

Infusum Pruni Virginian®. Dose, f^ij-iij (04. 
to 96. Gm.). 

Syrupus Pruni Virginian®. Dose, f ^ss (1G. Gm.). 



394 POWDERS — POMEGRANATE. 

Wild cherry bark is tonic and sedative, the freshly pre- 
pared preparations containing a small amount of hydrocyanic 
acid. The syrup, from its pleasant flavor, is much used as 
an ingredient in cough syrups for phthisis, or chronic 
bronchitis.'] 



[Pulveres. 

The officinal Powders are — 

Pulveres Effervescentes. — Soda, or effervescing powders. 

" " Aperientes. — Seidlitz powders. 

Pulvis Aloes et Canellse. — Hiera Picra (holy hitter). 

" Aromaticus. — Spice powder. 

" Ipecacuanhae Compositus. — Dover's powder. 

" Jalappe Compositus. — Jalap and cream of tartar. 

" Rhei Compositus. — Rhubarb, magnesia, and ginger.] 



PUNICA GRANATUM— POMEGRANATE. 

[Granati Fruetus Cortex. The rind of the fruit of 
Punic a Granatum, U. S. 

Granati Radieis Cortex. The bark of the root of 
Punica Granatum, U. S. 

Pelleterine (not oft*.). The active principle. Dose, gr. 
xv (1. Gm.). 

Physiological Action. Therapeutical Action. 

Pomegranate bark destroys It is much used as an an- 

a tape-worm, according to thehnintic in veterinary prac- 

Kiichenmeister, in three tice [and is sometimes given 

hours. [As it contains gallo- in infusion as a gargle, and 

tannic acid, it should not be as an injection in gonorrhoea. 

prescribed in combination A tape-worm may be dis- 

with metallic salts. It may charged in a few hours by 

be given in the form of the administering the decoction 

fluid extract (not officinal), or through a stomach tube, and 

it may be used in decoction following it by castor oil ; or 

(oij to Oj), as an astringent by a dose of the Pelleterine. 
wash.] 



QUASSIA — OAK, 



195 



QUASSIA—QUASSIA. 

[ The wood of Simarvba excel 'set, U. S. 

Officinal Preparations, U. S. 

Extraetum Quassias. Dose, gr. j-iij (.06 to .20 
Gm.). 

Infusum Quassias (5ij to Oj). Dose, f^j-ij (32. to 
64. Gm.). 

Tinetura Quassiae (5j to Oj). Dose, gtt. xx-f$j 
(1.30 to 4. Gm.).] 



Physiological Actions. 

The action of quassia is 
directed to the gastrointes- 
tinal mucous membrane, and 
it is probable that its in- 
tensely bitter taste may stim- 
ulate the secretion of gastric 
juice, as it certainly increases 
the appetite. 



Titer apeuticcd Actions. 

Quassia is much used as a 
tonic in dyspepsia, want of 
appetite, and general debility. 
Having no aromatic flavor, it 
is sometimes badly borne by 
weak stomachs, but, being- 
very cheap, it is largely pre- 
scribed in dispensary prac- 
tice, more especially in com- 
bination with iron. 



Quassia is destructive to It is therefore of service, 
many of the lower forms of given as an enema, for the 
animal life. destruction of thread-worms. 



QUERCUS— OAK. 

[QuerCUS Alba. The inner bark of Quereus alba, U. S. 
Quereus Tinctoria. The inner bark of Quereus 
tinctoria, U. S. 

Officinal Preparation, U. S. 

Decoctum Quereus Albae (^j to Oj). Dose, f siv 
(128. Gm.).] 

Oak bark contains tannic and gallic acids, and the decoc- 
tion is therefore of some value as Jin astringent in relaxed 
throat, leucorrhoca, etc. 



396 RESIN — RHUBARB, 



[RESINA— RESIN. 

The residue after the distillation of the volatile oil from the turpentine of 
Pinus palustris, and of other species of Pinus, U. S. 

Ceratum Resin®. 

Ceratum Resin® Composition. 

Emplastrum Resinae. 

Enters into Ceratum Cantharidis, Ceratum Extracti 
Cantharidis, Ceratum Sabinae, and Emplastrum Hydrargyri. 

Has no great therapeutic interest, except in its pharma- 
ceutical relations. It has been recommended in five grain 
doses for chronic diarrhoea, but is seldom used internally.] 



[Resinae. 

The officinal Resins are — 

Resina Jalapse Eesina Scammonii.] 

" Podophylli 



RHEUM—RHUBARB. 

[ The root of Rheuifi palmatum, and of other species of Rheum, from 
China, Chinese Tartar//, and 'Thibet, U. S. 

Officinal Preparations, U. S. 

Extraetum Rhei. Dose, gr. ij-xxx (.12 to 1.30 
Grn.). 

Extraetum Rhei Fluidum. Dose, gtt. x-xxv (.65 
to 1.60 Gm.). 

Infusum Rhei (5iv to Oj). Dose, f^ij-iv (64. to 
128. Gm.). 

Pilulaa Rhei (each, gr. iij). Dose, 2 to 8 pills. 

Pilulas Rhei Composite (Rhei gr. ij, aloes gr. iss). 
Dose, 2 to 4 pills. 

Pulvis Rhei Compositus (Rhubarb §iv; magnesia 
§xij ; and ginger §ij). Dose, 3 ss ~j (2- to 4. Gm.). 

Syrupus Rhei (giss to Oj). Dose, f^ss-j (16. to 32. 
Gm.). 

Syrupus Rhei Aromaticus (3yf to Oj). Dose, for 
infant, t'3j (4. Gm.). 



RHUBARB. 



397 



Tinetura Rhei (giss to Oj). Dose, f oss-j (16. to 32. 
Gm.). 

Tinetura Rhei et Sennae (§| to Oj). Dose, f^ss-j 
(16. to 32 Gm.). 

Vinum Rhei (^ij to Oj). Dose, f5j-iv (4. to 16. 
Gm.).] 

Constitutional Action. 



Physiological. 

Like castor oil, rhubarb 
combines some astringent 
properties with its undoubted 
cathartic effects ; and whilst 
the first mentioned action is 
no doubt due to the tannin 
which it contains, investiga- 
tors have not yet determined 
on what special ingredient 
its purgative powers depend. 

When taken in consider- 
able doses, it not only stimu- 
lates the peristaltic move- 
ments of the small intestine, 
and more especially the duo- 
denum, but it moistens and 
softens the feces, and in- 
creases most decidedly the 
secretion of bile, being, ac- 
cording to Rutherford, a cer- 
tain though not a powerful 
hepatic stimulant, the bile 
secreted under its influence 
having the normal compo- 
sition. 



The chrysophanic acid, or yellow coloring matter of 
rhubarb, is readily absorbed, and rapidly given out by the 
intestines, milk, sweat, and urine, to which latter secretion 
it imparts a yellow tinge, turning red on the addition of an 
alkali. [For use of chrysophanic acid in skin diseases, see 
Goa Powder in the succeeding section.] 
34 



Therapeutical. 

The astringent action of 
rhubarb renders it most use- 
ful in those forms of diar- 
rhoea depending on the pre- 
sence of indigestible matters 
in the alimentary canal, and 
where removal of the excit- 
ing cause, followed by rest 
of the irritated intestine, is 
sufficient to effect a cure. 

It is a good tonic in some 
cases of dyspepsia, and forms 
a good purgative for children, 
more especially when com- 
bined with magnesia, as in 
t h e w el 1 - k n o w n Gr egory ' s 
Powder [pulv. rhei comp.j. 

Prof. Rutherford's experi- 
ments on its cholagogue ac- 
tion would indicate its em- 
ployment in jaundice and 
deficient secretion of bile. 



398 



ROSE. 



Dose, Mode of Administration, etc. 

The- smell and flavor of rhubarb are excessively nauseous, 
and, although we cannot effectually disguise either, we may 
at least render the drug moderately palatable by the follow- 
ing formula? : — 

Gm. 



M. 



I£. Infusi rhei f §ij ; or 
Potassii bicarbouatis 3J 1 " 
Tincturae cinnamomi f5'j ; " 
Syrupi simpliois f3vj ; " 

Dose, f 5j secunda quaque liora. 


64 
4 
8 

24 


In the diarrhoea of children. 




$. Pulveris rhei gr. xxx ; or 
Sodii carbonatis gr. xv ; " 
Spiritus myristicae rr^xxx ; " 
Syrupi zingiberis f.3j ; " 
Aqua? mentlise piperita? q. s. ad f §iss ; " 

Misce, fiat liaustus uocte suniendus. 


2 
1 

2 

4 

48 


Antacid and purgative. 





Gm. 



M. 



ROSA— ROSE. 

[Rosa Centifolia. The petals of Rosa centifolia* U. S. 
Rosa Galliea. The petals of Rosa Gcdlica, U. S. 

Oleum Rosffi. The volatile oil obtained from the petals 
of Rosa centifolia, JJ. S. 

Officinal Preparations, U. S. 

Aqua Ros« (Rosa centifolia). As a vehicle. 
Confeetio RosaB. As an excipient for pills. 
Infusum Rosffi Compositum (containing sulphuric 
acid). As a vehicle. 

Mel Ros«. As a vehicle. 

Syrupus Rosa^ Galliea^. As a vehicle. 

Unguentum Aqua? Rosffi (cold cream). 

Also enters into Piluhe Aloe's et Mastiches, and Syrupus 
Sarsaparillre Compositus.] 

The various preparations of roses have little therapeutical 
significance. The cabbage-rose is used in the form of rose- 
water as an elegant vehicle ; the red-rose petals as confection 
constitute a convenient basis for a pill mass, whilst, com- 



ROSEMARY — RUE. 399 

bined with sulphuric acid in the acid infusion, they make an 
excellent gargle, either alone or with alum, whilst they may 
occasionally be of service in concealing the nauseous flavor 
of sulphate of magnesia. 

Hips [dog-rose, rosce canince fructus, Br.] are also 
slightly astringent. 



ROSMARINUS— ROSEMARY. 

[ The leaves of Rosmarinus officinalis, U. S. 

Oleum Rosmarini. Used in linimentum saponis. 

Is rarely used in this country except as a perfume.] 

Rosemary, lavender, and peppermint are agreeable car- 
minatives, much used in combination with other stimulant 
drills. 



[RUBUS— BLACKBERRY. 

The bark of the root of Rubus Canadensis and of Rubus villosus, U. S. 

Officinal Preparations, U. S. 

Extractum Rubi Fluidum. Dose, f5ss (2. Gm.). 
Syrupus Rubi. Dose, f 3j— ij (4. to 8. Gm.). 

Much prized as a tonic and astringent, and particularly 
adapted to the diarrhoea of relaxation. A decoction is also 
made in domestic practice (Jj to Oiss boiled down to a pint), 
of which fjj-ij (32. to 64. Gm.) may be given three or four 
times daily.] 



[RUTA—RUE. 

The leaves of Ruta Grareoleus, U. S. 

Oleum Rutae. Dose, gtt. iij-vj (.20 to .40 Gm.). 

Rue is stimulant, and in large doses, is an acro-narcotic 
poison. Moderate doses have some emmenagogue effects, 
and, in cases of poisoning, miscarriage generally occurs.] 



400 CEVADILLA. 

SABADILLA—CEVADILLA. 
[The seed of Veratrum Sabadilla (Retzius), U. S. 

Officinal Preparations. 

Veratria. Not used internally. 
Unguentum Veratriae (gr. xx to gj). 

Poisoning. 

In directly fatal doses, veratria depresses the whole nervous 
system ; the respiration and circulation are gradually sus- 
pended ; the convulsive movements, noticed under smaller 
doses, now pass into tetanus, the rigidity of the muscles of 
the chest impede respiration, and death takes place by as- 
phyxia (Dr. Stille). 1 

Antidotes. 

Vegetable astringent infusions, containing tannic acid, 
should be freely administered, the stomach washed out, fol- 
lowed by stimulants and an opium suppository, or enema. 
Tincture of digitalis would seem to be a physiological anti- 
dote. Whiskey may be given hypodermically on the ap- 
proach of collapse.] 

External Actions. 

Physiological. Therapeutical. 

The application of vera- Veratria has been used 

tria to the skin causes first with success as a local appli- 

pricking and tingling, fol- cation in cases of neuralgia 

lowed by redness and acute of the fifth nerve, but its irri- 

darting pain. To this sue- tating properties must always 

ceeds numbness, due, in all be a barrier to its extensive 

probability, to some local employment. [The officinal 

anaesthetic influence on the ointment generally requires 

extremities of the sensory dilution -^ to J. When used, 

nerves. care should be taken not to 

The slightest contact of rub the eyes with the greasy 

veratria with the nasal mu- fingers, as violent irritation 

cous membrane causes vio- may result.] 
lent irritation and prolonged 
sneezing. 

1 [National Dispensatory, Philada., 1879, p. 1478 ] 






SAVINE. 401 

Internal Actions. 

Veratria is never used internally in this country. 

Brain and Nervous System. — No action on the brain. 

Spinal Cord A good deal of elaborate, but unfortunately 

contradictory, experimental evidence has been adduced by 
various observers with reference to the effects of veratria on 
voluntary movement. In the first place convulsions and 
even tetanic spasms may be produced by the administration 
of the drug, but these are speedily followed by paralysis and 
complete muscular prostration ; and the balance of testi- 
mony goes to show that this is due to a primary exciting 
and secondary paralyzing action on the muscular structures 
themselves. 

Heart and Circulation Veratria first increases the action 

of the heart by stimulating its motor ganglia, but secondary 
slowing and depression rapidly ensue from an exciting action 
on the vagi. 

Respiration is at first quickened, but subsequently retarded 
by the lowering effect of the drug on the respiratory centre. 
The temperature of the body falls. 

Digestive and Secreting Organs Veratria often causes 

troublesome vomiting and purging. 



SABINA— SAVINE. 

[ The tops of Juniperis Sabina, U. S. 

Dose, in substance, gr. v-xv (.30 to 1. Gm.). 

Officinal Preparations, U. S. 

Ceratum Sabinae (fluid extract, fgiij ; resin cerate, 
3xij). 

Extraetum Sabinae Fluidum. Dose, gtt. v-xv 
(.30 to 1. Gm.). 

Oleum Sabinae. Dose, gtt. ij-v (.12 to .30 Gm.).] 

Local Effects. 

Savin used to be applied in the form of ointment to blis- 
tered surfaces, with the view of encouraging suppuration, 
but this barbarous process is now happily abandoned. [It 
is stimulant and rubefacient, and is sometimes applied to 
warts, ulcers, and diseases of the scalp.] 

34* 



402 SUGAR — SAGO. 

Internal Uses. 

Physiological. Therapeutical. 

Savin is a gastrointestinal Savin is sometimes used 

irritant, causing in large with criminal intent to pro- 
doses vomiting and purging; duce abortion, and death has 
and it has also a powerful occasionally resulted from its 
stimulating influence on the irritant action. It is rarely 
uterus. used in medicine, although 

some authorities express faith 
in its emmenagogue powers. 



SACCHARUM— SUGAR. 

[ The sugar of saccharum officinarum, refined, U. S. 

SYRUPUS FUSCUS— MOLASSES. 

The impure, dark-colored syrup, obtained in making sugar from 
Saccharum officinalis, U. S. 

Officinal Preparations. 

Sugar enters into Pilula Ferri Carbonatis, Pilulae Ferr 1 
Iodic] i, and the various syrups.] 

Sugar is principally used in the form of syrup as a flavoring 
adjunct. [Molasses is laxative; and molasses candy some- 
times forms a good substitute for more active remedies in 
treating constipation in children.] 



SACCHARUM LACTIS— SUGAR OF MILK. 

\_A crystalline substance obtained from ivhey, U. S. ] 

Milk, and sugar of milk, have no special therapeutical pro- 
perties apart from their nourishing qualities. 



[SAGO— SAGO. 

The prepared fecula of the pith of Sagus Rumphii, and other 
species of Sagus, U. S. 

Used, like arrowroot, as an article of diet for the sick, 
thoroughly boiled in water or milk fa tablespoonful to a pint) 
and flavored with sugar, lemon, spice, or wine, according to 
taste.] 



SAGE — BLOODROOT. 403 

[SALVIA— SAGE. 

The leaves of Salvia officinalis, U. S. 
Officinal Preparation, U. S. 

Infusum Sal viae (ass to Oj). Used as a gargle. 

Sage is tonic, astringent, and aromatic. It has been used 
as a carminative in debility of the stomach with flatulence, 
and the infusion is a useful gargle, to which honey, alum, 
or vinegar may be added, but it strikes a black color with 
iron (it contains tannic acid). A weak infusion is sometimes 
used as a drink in fevers to allay nausea.] 



SAMBUCUS— ELDER. 

I The flowers of Sambucus Canadensis, U. S.J 

Only used in the form of aquae sambuci [Br.], which is a 
cooling and pleasant lotion. [The root of Sambucus nigra 
(common, black elder-berry) acts as a hydragogue cathartic. 
The expressed juice of the root may be given in closes of 
^j-ij until salivation, vomiting, and purging occur; or a 
decoction may also be made.] 



SANGUINARIA— BLOODROOT. 

[ The rhizome of Sanguinaria Canadensis, U. S. 
Officinal Preparations, U. S. 

Acetum Sanguinariae (gij to Oj). Dose, i^xv-xxx 
(1. to 2. Gm.). 

Tinetura Sanguinariae (gij to Oj). Dose, gtt. xx- 
xl (1.30 to 2.60 Gm.).] 

This is a substance of energetic physiological properties, 
causing clonic convulsions of spinal origin, diminishing 
reflex action, weakening the force of the heart, and lessen- 
ing arterial tension, lowering the temperature, dilating the 
pupil, and finally causing deatli by respiratory paralysis. It 
also possesses violent emetic properties, and stimulates he- 
patic secretion. It has been used more especially in America, 
and has been found useful in atonic dyspepsia and duodenal 
jaundice, in chronic catarrh, and some stages of bronchitis, 
and may be given in doses of 5 to 10 minims of the tine- 



404 



RED SAUNDERS — SANTONICA. 



ture three times a day. [The powdered root has been used 
as a stimulant in indolent ulcers, which has led some to con- 
sider it a specific for cancer /] 



[SANTALUM— RED SAUNDERS. 

The wood of Ptei'ocarpus santilina, U. S. 

Used only in pharmacy as a coloring agent, and enters 
into Spiritus Lavandulae Compositus.] 



SANTONICA— SANTONICA. 

The xmexpanded flowers of Artemisia Cina. (Willkomm Botanische 
Zeitung, 1872, No. 9), U. S. 

Officinal Preparations, U. S. 

Santonimim. Dose, gr. ss-iij (.03 to .20 Gm.). 
Troehisei Santonini (each, gr. ss).] 

Local Actions. 
Santonin has no local action. 



Internal Actions. 



Physiological. 

I. Brain and Nervous Sys- 
tem — It is no doubt due to 
some influence on the brain 
that the peculiar derange- 
ment of vision, which is some- 
times found accompanying 
the use of santonin, de- 
pends ; as no staining of the 
ocular media has been ob- 
served, and slight hyperemia 
of the retina is the only ap- 
parent local effect. Some 
observers note the first stage 
to be an exaggerated appre- 
ciation of the violet rays of 
the spectrum, but the most 



Therapeutical. 



I. Santonin has been re- 
commended as a remedy for 
some affections of the optic 
nerve, but no trustworthy 
evidence has yet been adduced 
of its efficacy. 



SANTONICA. 



405 



evident alteration in sight 
consists in very distinct yel- 
low vision, all white objects 
being seen in a more or less 
pronounced saffron tinge, 
which begins about half an 
hour after the drug is swal- 
lowed. Associated with this 
we find a diminished or even 
abolished appreciation of the 
violet rays of the spectrum. 
A good deal of lassitude and 
mental depression usually 
follows the use of this medi- 
cine, and it must be cau- 
tiously pushed, as large doses 
have occasionally proved 
fatal from tetanic spasms and 
convulsions and coma. 

II. Respiration and Cir- 
culation No special influ- 
ence on these functions has 
been noted. [In poisoning 
there is accelerated and 
feeble pulse and rapid respi- 
ration.] 

III. Secreting Organs. — 
Slight digestive disturbance 
is usually experienced, indi- 
cated by nausea, headache, 
and general malaise. 



Urinary Organs Re- 
markable effects are here 
noted, consisting of a bright 
yellow coloration of the 
urine, beginning five min- 
utes after a few grains have 
been swallowed, persisting 



Santonin has not been used 
in any form of nerve disease, 
but it seems at least possible 
that it might prove of service 
in some forms of so-called 
color-blindness. 



III. The real use of san- 
tonin in practice consists in 
its effect on the round worm, 
or ascaris lumbricoides, 
which it speedily destroys. 
It appears to have no influ- 
ence over the tape-worm, 
and it is an open question 
with regard to its service in 
cases of ascaris vermicularis. 



406 SANTONICA. 

for two or three days, and 
communicating a stain to 
linen, as in the case of jaun- 
dice. Should the urine hap- 
pen to be alkaline, the color 
assumes a blood- red tinge, 
and the same change fol- 
lows the addition of ammo- 
nia to the acid secretion. Santonin has been recom- 
At the same time the flow mended as a remedy for in- 
of urine is increased, the pa- continence of urine, and is 
tient experiences an irresist- said to succeed occasionally 
ible desire to micturate, and in cases of this troublesome 
in the case of children this atfection after other remedies 
may even give rise to com- have failed, 
plete temporary incontinence. 

Mode of Elimination. 

Santonin is supposed to combine with the soda in the 
blood, and to be given out, in part at least, by the urine. 

Cautions. Mode of Administration. 

[Prof. Binz has related a case of santonin-poisoning in 
which, apparently, a small dose produced serious symptoms. 
Two lozenges, containing less than a grain, were followed, 
10 hours afterwards, by a convulsive attack which recurred 
several times during the next few days. The child never 
had convulsions before. It would seem as if the troches 
must have contained more of the drug than was suspected. 1 ] 

As already observed, serious symptoms have been observed 
to follow the use of santonin, and we shall do well to warn 
our patients of the urinary irritability which is invariably 
experienced in greater or less degree. Dr. Sieveking has 
also drawn attention to the occurrence of urticaria following 
the administration of santonin, and Drs. Dyce and Ogson 
have given a suggestive hint by pointing out that its long- 
continued use causes the development of cataract in young 
animals. 

[When retained in the system santonin becomes converted 
into xanthopsin, which appears in the urine. Poisonous 

1 [Phil. Med. Times, Aug. 1877, p. 551.] 



SOAP — SARSAPARILLA. 407 

symptoms are produced by this new substance, but they may 
be prevented by combining the santonin with an antacid 
and purgative, and in practice it is found that they are 
never produced when the santonin is combined with calomel, 
and soda.] 

Its taste is not unpleasant, but as it is insoluble in water 
it may be mixed with jam or treacle, or simply sprinkled on 
bread and butter [or preferably, in the officinal lozenge.] 



SAPO— SOAP. 

Soap made with soda and olive oil, U. S. 

Officinal Preparations, U. S. 

Ceratum Saponis. 
Emplastrum Saponis. 
Linimentum Saponis. 
Pilulae Saponis Compositae. 

Enters into Extractum Colocynthidis Compositum, Pilulas 
Aloes, Pil. Aloes et Assafoetidae, Pil. Assafoetidae, Pil. 
Opii, Pil. Rhei, Pil. Rhei Compositae, and Pil. Scillae Com- 
positae.] 

Soap is not applied to any therapeutical purpose, except 
the hard variety, which enters into the construction of some 
pill masses, and both the hard and soft aid in the construc- 
tion of liniments and plasters. 

[Soft, or potassa-soap, sometimes termed green soap, sapo 
viridts, has been recommended by Hebra in alcoholic solu- 
tion, under the name of spiritus saponis kalinis (2 pts. soap, 
1 pt. alcohol), in the treatment of chronic eczema.] 



SARSAPARILLA—SARSAPARILLA. 

[ The root of Smilax officinalis {Humboldt and Bonjilandt) and of other 
species of Smilax, U. S. 

Officinal Preparations, U. S. 

Deeoetum Sarsaparilla? Compositum (sarsapa- 
rilla, sassafras, guaiac, mezereon, and liquorice). Dose, 
f*iv (128. Gnu). 

Extractum Sarsaparilla? Fluidum. Dose, fjss 
(2. Gm.). 



408 



SASSAFRAS. 



Extraetum Sarsaparillae Compositum Flu- 
idum. Dose, f"5j (4. Gm.). 

Syrupus Sarsaparillae Compositus (giv to Oj). 
Dose, fgss (16. Gm.).] 

Internal Actions. 



Physiological. 

Sarsaparilla has been cre- 
dited with diaphoretic, diu- 
retic, and other powers ; but 
none of these have stood the 
test of rigid investigation, 
and it is difficult to find any 
convenient heading under 
which to class this popular 
drug, unless we shelve the 
difficulty by calling it an 
" alterative." 



Therapeutical. 

Nor is it easier to give 
any decided opinion regard- 
ing its therapeutical merits ; 
for whilst some surgeons, 
like the late Mr. Syme, hold 
it to be quite useless, others 
believe it to be of service 
in constitutional syphilis, 
chronic skin disease, etc. 
One point of difficulty in ar- 
riving at any decided con- 
clusion is, that it is usually 
prescribed along with three 
other drugs in the compound 
decoction ; but the late Mr. 
Gascoyne used to say that he 
had found great benefit in 
the treatment of the tertiary 
forms of syphilis by giving 
full doses of the freshly made 
infusion. 



SASSAFRAS— SASSAFRAS. 

[ The bark of the root of Sassafras officinale, U. S. 
Sassafras Medulla. The pith of the stems of Sassa- 



fras officinale, U. S. 
Oleum Sassafras. 



Dose, gtt. ij-x (.12 to .62 Gm.). 



Officinal Preparation, U. S. 

Mueilago Sassafras Medullar (5ij to Oj). 
Enters into Extraetum Sarsaparilla; Compositum Fluidum, 
and Decoctum Sarsaparillae Compositum.] 

This plant seems only to have acquired any therapeutic 



SCAMMONY — SQUILL. 409 

importance by reason of its combination with other drugs 
in the decoctum safsaparillae com p. The mucilage may be 
used as a soothing application in conjunctivitis. [The oil is a 
pleasant flavoring substance, and is considered carminative.] 



SCAMMONIUM— SCAMMONY. 

[A resinous exudation from the root of Convolvulus Scammonia, U. S. 
Dose, in substance, gr. v-xv (.30 to 1. 6m.). 

Officinal Preparations, U. S. 

Resina Seammonii. Dose (given in milk), gr. iv-viij 
(.25 to .50 Gra.). 

Extractum Coloeynthidis Compositum. Dose, 
gr. v-xxx (.30 to 2. Gm.).] 

Internal Effects. 
Physiological. Therapeutical. 
Scammony causes a good Scammony is a purgative 
deal of irritation of the ali- used in cerebral and dropsical 
mentary canal, and produces affections; and, being corn- 
copious watery stools, often paratively tasteless, it is well 
attended with griping. For adapted for children, forming 
its proper action, previous a convenient purgative for 
solution in the bile, and com- the removal of ascarides. 
bination with its soda, are 
requisite. 



SCILLA— SQUILL. 

[The bulb of Scilhe maritima, U. S. 

Dose, in substance, gr. ij (.12 Gm.). 

Active principles, scillin and skulein (or scillitin), the lat- 
ter being most tonic and bitter. 

Officinal Preparations, U. S. 

Acetum Seillae (sij to Oj). Dose, nrx-3j (.65 to 4. 
Gm.). 

Syrupus Seillae. (Acetum Seillae with sugar). Dose, 

the same. 

Pilulae Seillas Compositae (Squill gr. ss, ammoniac 

and ginger each gr. j). Dose, 3 to 5 pills. 
35 



410 



BROOM. 



Syrupus Seillse Compositus (Tartar emetic gr. j in 
fgj). Dose, gtt. x-f5j (.60 to 4. Gm.). 

Tinctura Scillse (§iij to Oj). Dose, n^x-xx (.65 to 
1.30 Gm.) 

Extr actum Scillae Fluidum. Dose, n^ij-iij (.12 to 
.20 Gm.).] 

Internal Effects. 



Physiological. 

In large doses, squill may 
act as an emetic, and cause 
violent vomiting with purg- 
ing. 

It also stimulates the bron- 
chial mucous membrane, and 
increases the urinary secre- 
tion. 



Therapeutical. 

Squill is never used as an 
emetic [except, in its combi- 
nation with tartar emetic as 
"HiveSyrup"(SyrupusScilke 
Compositus), which has been 
recommended in spasmodic 
croup. It may be repeated 
at short intervals, until 
vomiting occurs.] 

It is, however, a good ex- 
pectorant, increasing the 
bronchial secretions, and is 
one of the most universal 
additions to prescriptions for 
the relief of various chronic 
lung affections, as bronchitis, 
and also in whooping-cough. 

It is also a tolerably effi- 
cient diuretic, only to be 
used, however, when no irri- 
tation exists about the kid- 
neys. 



SCOPARIUS— BROOM. 

[ The tops of Sarothamnus Scoparius (Wimmer), U. S.~\ 

Local Effects. 
No local action has been described. 



Constitutional Actions. 

Scoparius has some influ- Scoparius is an excellent 
ence over the digestive and diuretic, and is largely used 



BROOM. 



411 



secreting organs, causing, in 
large doses, vomiting and 
purging, but in smaller in- 
creasing very considerably 
the urinary water. Two 
active principles have been 
extracted from the drug, re- 
garding whose physiological 
actions some difference of 
opinion exists. Thus scopa- 
rix is believed by one class 
of observers to be the diu- 
retic factor in broom-tops, 
whilst others assert that it 
has no such property. S par- 
te ix has also been very va- 
riously described, but the 
balance of testimony goes to 
show that it has very definite 
toxic powers, lowering the 
reflex action of the spinal 
cord, paralyzing the motor 
nerves, suspending the elec- 
trical excitability of the va- 
gus, and finally causing death 
by respiratory paralysis. 



for the purpose of removing 
dropsical accumulations. If 
we can succeed in stimulating 
the kidneys effectually by a 
combination of this and other 
drugs, we may hope to hold 
in check and disperse the 
anasarca of cardiac and 
chronic kidney-disease, and 
to aid the removal of the 
watery fluid of hydrothorax 
and ascites. [An infusion of 
scoparius (§j to Oj), in con- 
junction with purging by 
compound jalap powder, is 
often used in cardiac dropsy, 
to relieve an overloaded right 
side of the heart, with mitral 
insufficiency.] 



Dose axd Mode of Admixistratiox. 

Scoparius is seldom prescribed alone, but is most usually 
made the basis of diuretic mixtures, on the well-known prin- 
ciple of combination, which is here of essential service. 



R. Potassif acetatis 3i ss ! or 6 

Aceti scillae f'.^iv ; " 16 

Decocti scoparii [Br.] q. s. ad f^vj ; " 192 

Fiat mistura. Capiat unciam unam quartis horis. 



Gm. 



R. Tincturse digitalis Tt[x ; or 
Spiritus SBtlieris nitrosi, 

Spiritus juniper!, aaf.^ss; " 2 

Succi scoparii [Br.] f 3.1 ; " 4 1 

Aquae q. s. ad f^j ; " 32, 

S. Fiat haustus, ter die sumeudus. 



'65 Gi 



M. 



M. 



412 SENEKA. 

SENEGA— SENEKA. 

[ The root of Polygala Senega, U. S. 

Dose, in substance, gr. xx (1.30 Gm.). 

Officinal Preparations, U. S. 

Deeoetum Senegae (sj to Oj). Dose, f gj (32. Gm.). 

Extraetum Senegae (alcoholic). Dose, gr. j-iij (.06 
to .20 Gm.). 

Extraetum Senegas Fluidum. Dose, n^x-xxx 
(.Go to 2. Gm.) 

Syrupus Senegae. Dose, f£j (4. Gm.). 

It also enters into Syrupus Scillre Compositus.] 

Local Effects. 
No external or local action lias been described. 

Constitutional Actions. 
Physiological. Therapeutical. 

The principal action of Senega is of great service 
senega is that of stimulating in the more chronic condi- 
the mucous membrane of the tions of pneumonia and bron- 
bronchial tubes, and possi- chitis, where it seems to help 
bly, by a tonic influence on the patient to get rid of the 
their muscular tissues, facili- large quantities of secretion 
tating the expulsion of their frequently accumulated 
contents. It has also been within the lungs. Theoreti- 
accredited with diaphoretic, cally at least, its stimulating 
diuretic, and emmenagogue properties would contra-indi- 
properties, but is seldom em- cate its use in the more acute 
ployed in any other capacity pulmonary affections, but in 
than as an expectorant. the later stages of bronchitis, 

and more especially those 
cases occurring among the 
very old, or young, it is of real 
value. 

Dose and Mode of Administration. 

The infusion is the preparation most commonly employed, 
and it is generally combined with carbonate of ammonia and 
other expectorants. Thus : — 



SENNA. 



413 



R. Ammorrii carbonatis gr. iv ; 

Tincturse scillne tt^xv ; 

Tinct. opii camphorat. ff\,xxv ; 

Extracti glycyrrhizre gr. v ; 

Infusi senegre [Br.] q. s. ad. f§j ; 
Fiat haustus ter die sumendus. 



or |25 Gm. 



M. 



SENNA— SENNA. 

[ The leaflets of Cassia acutifolia (Delile), of Cassia abovata (De Can- 
dolle), and of Cassia elongata (Le)naire, Journ. de Pharm., vii. 
345), U. S. 

Officinal Preparations, U. S. 

Confeetio Sennae. Dose, Sij-ij (4 to 8 Gm.). 

Extraetum Sennae Fluidum. Dose, f^j-iv (4. to 
16. Gm.). 

Infusum Sennae (gj to Oj). Dose, fgij-iv (64. to 
128. Gm.). 

Tinctura Rhei et Sennae. Dose, f^ss-ij (16. to 
64. Gm.), 

And enters into Syrupus Sarsaparillae Comp.] 

Internal Effects. 



Physiological. 

Senna irritates the small 
intestine, causing copious, 
thin, yellow evacuations, and 
stimulating the peristaltic 
movements of the bowel. 



Therapeutical. 

Senna is a most useful 
purgative, ranking among the 
cathartics with slightly dras- 
tic tendencies, and it may be 
prescribed in simple consti- 
pation, in dyspepsia, and in 
a large variety of conditions 
where rapid and effectual 
unloading of the bowels is 
required. 

Dose and Mode of Administration. 

Senna is seldom prescribed alone, as it is then apt to 
cause irregular contraction of the intestines and griping. It 
is therefore usually combined either with other purgatives, 
as mag. sulph. (black draught), or with various aromatics, 
as in the confection and compound mixture. 

3;')* 



414 VIRGINIA SNAKEROOT — MUSTARD. 

Cassia and tamarinds have both a slightly purgative 
action, but are only used as ingredients in various compound 
preparations, as the confection of senna. [The syrup of senna 
(not officinal) is a good purgative for young children, dose 
f 5j-iij. It makes a good emulsion with castor oil.] 



SERPENTARIA— VIRGINIA SNAKEROOT. 

\_The root of Aristolochia Serpentaria, of Aristolochia reticulata, and of 
other species of Aristolochia, U. S. 

Officinal Preparations, IT. S. 

Extractum Serpentarise Fluidum. Dose, gtt. xx 
(1.30 Gm.). 

Infusum Serpentarffi (§ss to Oj). Dose, fsj-iv 
(32. to 128. Gm.). 

Tinetura Serpentarise. (gij to Oj). Dose, f 3j-ij 
(4. to 8. Gm.).] 

This drug is probably a bitter tonic, but the other virtues 
with which it has been credited seem to rest on no very 
stable foundation. [It belongs to the class of the aromatic 
bitters, and is a good addition to other tonics, as cinchona, 
and is included in the composition of the popular Huxham's 
tincture — Tinetura Cinchonas Comp.] 



SEVUM— SUET. 

[ The prepared suet of Ovis Aries, U. S. 

Used only in pharmacy, and as an ingredient in Ceratum 
Resinoe Compositum, Unguentum Tlydrargyri, and Ung. 
Picis Liquidoe. 

An ointment made by adding calomel gr. v-x to suet ^j is 
used with good effect in eczema capitis.^ 



SIN APIS— MUSTARD. 

[Sinapis Alba. The seed of Sinapis alba, U. S. 
Sinapis Nigra. The seed of Sinapis nigra, U. S. 

Officinal Preparation, U. S. 
Charta Sinapis. Mustard papers (4 inches square).] 



MUSTARD. 



415 



Local Actions. 



Physiological. 

Mustard applied to the 
skin causes a vivid redness, 
with violent smarting and 
itching, and, if the applica- 
tion be continued too long, 
vesication may follow, and 
even troublesome ulceration. 

[This is said not to happen 
when mustard papers are used, 
or when tissue paper is placed 
on the front of the poultice.] 



2. [The irritation of the 
peripheral extremities of the 
sensory nerves in the skin by 
the action of the volatile oil, 
is reflected to the centres 
from which these nerves arise, 
producing revulsive effects ; 
and, by reflex action, through 
the vasor-motor nerves, it thus 
influences the conditions of 
vascularity and nutrition of 
adjacent organs, the brain or 
the lungs, for instance.] 



l 1 herapeutical. 

aid is used, fir 
the relief of pain, and there 
can be no doubt that benefit 
is thus derived in many ner- 
vous, rheumatic, and inflam- 
matory affections. In neural- 
gia, lumbago, sciatica, pleu- 
rodynia, pleurisy, pneumo- 
nia, peritonitis, colic, and a 
vast variety of painful dis- 
orders, we may expect to 
alleviate suffering in some 
measure by the use of sina- 
pisms, and at other times we 
use this mode of drawing 
blood to the surface, and so 
relieving the congestion of 
deeper parts, on the principle 
referred to under the heading 
of "Counter-irritation." [p. 
69.] 

2. Mustard poultices are 
most valuable in arousing pa- 
tients from the dangerous co- 
matose condition into which 
they occasionally drift in the 
course of some of the acute in- 
flammations ; and sinapisms 
applied to the feet and calves 
are of service in the stupor 
of narcotic poisoning and in 
urcemic coma. 



Mustard baths may be em- 
ployed to bring back the erup- 
tion of some abortive cases 
of the exanthemata, or as a 
stimulant in acnte bronchitis, 
or in the convulsions of chil- 
dren. 



416 SODIUM. 

Constitutional Actions. 
Physiological. TJierapentical. 

Digestive Organs Mus- Mustard is extensively 

tard increases the appetite by used as a dietetic condiment, 
irritating the mucous mem- 
brane of the stomach, but 
does not increase the secre- 
tion of gastric juice. 

It acts as a prompt and This emetic power is of 
effectual emetic of the direct great value in cases of poison- 
class, ing. as mustard is always at 

hand, and can be used at 
once. 

Mode of Administration. 

A mustard poultice must be made with cold water, for we 
know that hot water dissipates the volatile oil on which the 
counter-irritation depends, vinegar destroys it, and alcohol 
prevents its formation. It must be kept on from twenty 
minutes to half an hour, according to circumstances. [Very 
strong mustard may have too much effect upon tender skins, 
and it should always be mixed with flour or starch for children.] 



SODIUM— SODIUM. 

[Sodii Aeetas. Acetate of Sodium. Dose, gr. xx-5ij 
(1.30 to 8. Gm.). 

Sodii Biearbonas Venalis. (Used in making Aqua 
Acidi Carbonici, and Sodii Biearbonas.. 

Sodii Boras (Borax). 1 Dose,gr. x-xl (.05 to 2. GO Gm.). 
Mel Sodii Boratis (3j to f si). 
Glyceritum Sodii Boratis (5ij to f^j). 

Sodii Carbonas. (In making Aluminii Sulphas, Anti- 
monii Oxysulphuretum, Bismuthi Subnitras, Cadmii Sul- 
phas, Bismuthi Subcarbonas, Calcii Carbonas Prrecipitata, 
Ferri Subcarbonas, Liquor Sodse, Liquor Sodas Chlorinatas, 
Pilula Ferri Carbonatis, Pilulae Ferri Composite, Potassii 
et Sodii Tartras, Sodii Carbonas Exsiccata, Sodii Phosphis, 
and Zinci Carbonas Praeeipitata.) 

Sodii Chloridum (table-salt). (For making Calomel 
and Corrosive Sublimate.) 

1 For Boracic Acid, see page 441. 



SODIUM. 417 

Sodii Hypophosphis. Dose, gr. x-xxx (.65 to 2. 

Gm.). 

Sodii Hyposulphis. Dose, gr. x-xx (.65 to 1.30 
Gm.). 

Sodii Nitras. (For making Sodii Arsenias.) 

Sodii Sulphas. Glauber's Salt. Dose, *ss-j (16. to 
32. Gm.). (Also used in making Sodii Carbonas.) 

Sodii Sulphis. Dose, gr. xx-3j (1.30 to 4. Gm.). 

Officinal Preparations, U. S. 

Soda. Caustic Soda. 

Liquor Soda?. Dose, well diluted, nrv-x (.30 to .65 
Gm.). 
Sodii Arsenias. Dose, gr. T \- ^ (.005 to .02 Gm.). 
Liquor Sodii Arseniatis. Dose, n^iij-v (.20 to .30 
Gm.). 
Sodii Biearbonas. Dose, gr. x-xx (.65 to 1.30 Gm.). 
Pulveres Etfervescentes. Soda poivders. 
Pulveres EtFervescentes Aperientes. Seidlitz poivders. 
Trochisci Sodii Bicarbonatis. 
Sodii Carbonas Exsiceata. (Used in making Sodii 
Arsenias.) 

Sodii Phosphas. Dose, as a cholagogue, gr. xx-xl, or 
as a purgative, oj-ij (1-30 to 64. Gm.). (Used in making 
Ferri Phosphas and Ferri Pyrophosphas.) 

Liquor Soda? Chlorinatas. Labarraque's Solution. 
Dose, i'5 ss -j (-• t0 4. Gm.), well diluted. 

Poisoning. 

Soda is a corrosive mineral poison, and its symptoms and 
morbid appearances are analogous to those following the use 
of potassa. 

Tests. 

Caustic soda in solution is not precipitated by bichloride 
of platinum, or tartaric acid ; its alkaline nature can be 
ascertained by the usual tests. Antimoniate of potassium 
affords a white precipitate when added to the salts of soda. 
Soda tinges the outer flame of the blowpipe yellow. 

Antidotes. 
The same as for potassa.] 



418 SEIDLITZ POWDER. 



Effects and Uses. 

The soda salts have none of the depressing action on the 
heart which we have seen to be possessed by potash. 

Locally, we may use soda in acute eczema ; or the hypo- 
sulphite in parasitic skin-disease, where it acts in virtue of 
the contained sulphurous acid ; and the biborate, or borax, as 
a gargle, as a lotion in pruritus and various skin diseases, and 
as an application to aphthous ulcerations about the mouth. 

A saturated solution of carbonate of soda is said to be a 
very soothing application in burns. [It must be applied 
cold, and, therefore, is not. well adapted to cases where a 
large area is injured, but it may be applied freely in the dry 
form of the bicarbonate.] 

Soda is not so much used internally as a remedy for gout 
and rheumatism, because the urate of soda is less soluble 
than the urate of potash ; but it is one of our best remedies 
in those forms of dyspepsia with pain after food, weight at 
the stomach, red fissured tongue, cough, and palpitation. 
The hyposulphite is useful in sarciuous vomiting. 

[The bicarbonate is a remedy of value in irritability of 
the bladder. It is also frequently used in combination with 
syrup of rhubarb in catarrhal jaimdice.'] 

Sodium chloride is a good emetic ; the phosphate and tar- 
trate are purgative, but none of the preparations appear to 
be decidedly diuretic in their action. Sodium sulphate and 
phosphate have been found by Rutherford to increase the 
secretion of bile. 

Seidlitz Powder. Pulvis Effervescens Aperiens. 

am. 



~fy. Potassii et soclii tart. gij ; or 8 

Sodii bicarbonatis gr. xl ; " 2 

Misce, ut fiat liaustus effervescens cum 

Acidi tartarici gr. xxxv ; " 2 

Aquae f f iv ; " 128 

Statim sumendus. 



[The addition of a drop of oil of lemon to the powders 
greatly improves their taste. 

In cases of obstinate vomiting with constipation, broken 
doses of Seidlitz powders given frequently (say J of each 
powder in an ounce of water, given, whilst effervescing, every 
fifteen minutes) are very useful. Impaction of feces may 
often be overcome by frequent doses of these powders.] 



PINKROOT. 419 

$. Sodii bicarbonatis gr. xx; or 1130 Gm. 

Tinct. calumbae r\xx ; " 130 " 

Syrupi zingiberis f 3^« ', " - 

Infusi gentiaiise cornpositi q. s. ad f§j ; " 32 ( 

Misce, ter die sumend. 

Useful draught in dyspepsia. 

[The following is a pleasant antacid combination, known 
as : — 

Soda-Mint. 

I£. Sodii bicarbonatis, 

Sacchari, aa gij ; or 81 Gm. 

Spiritus ammonia? aromatici v\xl " 2j60 " 

Aqua? mentha? piperita? q. s. ad f |viij ; " 256[ " 

M. S. Dose, a tablespoouful after meals. 

Used in flatulent dyspepsia. It admits of the addition of 
tincture of mix vomica, or syrup of rhubarb. 

Compressed pills of soda-mint, for making the solution 
extemporaneously, may also be obtained from druggists.] 



[SPIGELIA— PINKROOT. 

The root of Spigelia Marilandica, U. S. 

Dose, in substance, 5j (4. Gm.). 

Officinal Preparations. 

Extractum Spigelian Fluidum. Dose, f5j-ij (4. 
to 8. Gm.). 

Extractum Spigelian et Sennas Fluidum. Dose, 
f 5ij— iv (8. to 16. Gm.). 

Infusum Spigelian (sss to Oj). Dose, fgiv-vlij (128 
to 256. Gm.) ; for a child, f 5ij-f'3j (8. to 32. Gm.). 

Spigelia is an efficient remedy against the round ivorms, 
or lumbricoids, and in moderate doses is entirely safe ; but 
in overdoses has narcotic properties. It is given in infusion 
or syrup, morning and evening, for two or three days, fol- 
lowed by a brisk cathartic. The chief objection to the use 
of spigelia is, that it imparts its red color to the clothing, 
and, if the baby vomits after taking a dose, it is likely to 
cause trouble.] 



420 WHISKEY — MARSH-ROSEMARY. 

[Spiritus. 

List of Spirits officinal in the U. S. P. : — 

Spiritus iEtheris Compositus Spiritus Juniperi Compositus 

" " Nitrosi " Lavandula 

" Ammonise " " Compositus 

" " Arouiaticus " Limonis 

" Anisi " Menthae Piperita 

" Camphorse " " Viridis 

" Chloroformi " Myrciae 

" Cinnamomi " Myristicae 

" Frumenti " Vini Gallici.] 

" Juniperi 



[SPIRITUS FRUMENTI— WHISKEY. 

Spirit obtained from fermented grain by distillation, and containing fr 
48 to 56 per cent by volume of absolute alcohol, U. S.] 



[SPIRITUS MYRCIJE— BAY-RUM. 

The spirit obtained by distilling rum with the leaves of Myrcia ac?is, 
(Schwartz), U. S.] 



[SPIRITUS VINI GALLICI— BRANDY. 

nrit obtained from fermented grapes by d 
"row. 48 to 50 per cent., by volume, qfabst 

For effects and uses, see Alcohol.] 



The spirit obtained from fermented grapes by distillation, and containing 
from 48 to 50 per cent., by volume, of absolute alcohol, U. S. 



[STATICE— MARSH-ROSEMARY. 

The root of Statice Limonium Caroliniana, U. S. 

Statice is a powerful, indigenous astringent, and may be 
used as a substitute for kino and catechu. It has been quite 
popular as an application to ulceration of the throat. In 
scarlatina, it is used both as an internal and local remedy. 
The infusion or decoction is generally employed.] 



STILLINGIA — STRAMONIUM. 421 

[STILLINGIA— STILLINGIA. 

The root of Stilling ia sulvatica, U. S. 
Dose, in substance, gr. xx (1.30 Gm.). 

Officinal Preparation, U. S. 

Extraetum Stilling® Fluidum. Dose, T^xx-xl 
(1.30 to 2.60 Gm.). 

Stillingia is highly esteemed as an alterative in secondary 
syphilis, shin disease, and scrofula. In large doses it is 
emetic and cathartic. As an alterative, it is frequently given 
in combination with sarsaparilla. A decoction (5j to Oiij 
boiled to Oj), dose, f.lj-ij (32. to 64. Gm.); and a tincture 
(31J to Oj), dose, f 3j (4. Gm.), are largely used in the South, 
but are not officinal.] 

STRAMONIUM—STRAMONIUM. 

[Stramonii Folium. The leaves of Datura stramo- 
nium, II. S. 

Stramonii Semen. The seed of Datura stramonium, 
U. S. 

Officinal Preparations, U. S. 

Extraetum Stramonii Foliorum. Dose, gr. J-J 
(.015 to .03 Gm.). 

Extraetum Stramonii Seminis. Dose, the same. 

Tinetura Stramonii (seeds 31J to Oj). Dose, r^x-xx 
(.65 to 1.30 Gm.). 

Unguentum Stramonii (extract, 5j to §j). 

Antidotes. 

The same as for belladonna-poisoning. See page 175.] 

After the careful description already given of the actions 
and uses of belladonna, it is unnecessary to say much about 
stramonium. Modern investigation has shown that the active 
principle, daturia, is identical with atropia; and the only 
marked difference between the two plants seems to consist 
in the more decided antispasmodic properties of stramonium, 
36 



422 STORAX — SULPHUR. 

■which cause it to be much prized as a remedy for asthma. 
In the purely spasmodic varieties of that disease, and most 
efficiently when inhaled in the form of smoke, it seldom fails 
to give relief. [The ointment is used for hcemorrhoids.'] 



[STYRAX—STORAX. 

A balsam -prepared from the bark of Liquidambar orientate 
{Lamarck), JJ. S. 

Storax has been recommended as a substitute for copaiba 
in the treatment of gonorrJicea and gleet ; and mixed with 
olive oil, equal parts, is effectual in the treatment of scabies. 
It is ranked as a stimulating expectorant, but is chiefly used 
as an ingredient in the compound tincture of benzoin.] 



[Succi. 

The officinal Juices are — 

Succus Coiiii Suecus Taraxaci.] 



SULPHUR— SULPHUR. 

[Sulphur Lotum. Sublimed sulphur, thoroughly 
washed with loater, U. S. 

Sulphur Sublimatum. Sublimed sulphur, U. S. 

Officinal Preparations, U. S. 

Sulphur Praeeipitatum. Dose, 3j-"j (4. to 12. 
Gm.). 

Sulphuris Iodidum. Not used internally. 

Unguentum Sulphuris (1 part sulphur, 2 parts 
lard). 

Unguentnm Sulphuris Iodidi (gr. xxx to gj). 

Sodii Hyposulphis. Dose, gr. xv (1. Gm.). 

Sodii Sulphis. \ Dose, gr. xx to 3j)- 

Potassii Sulphis. } (1.30 to 4. Gm.) 

Sublimed sulphur is used in making Emplastrum Ammo- 
niaci cum Hydrargyro, Hydrargyri Sulphuretum Rubrum, 
Potassii Sulphuretum, Sulphur Pnecipitatum, and Sulphuris 
Iodium.] 



SULPIIUR. 



423 



External Use. 

Sulphur is used externally as a stimulant in various forms 
of chronic skin disease, such as acne faciei, and more espe- 
cially in itch, a disease dependant on the presence of a 
minute insect, the acarus scabiei, the male of which ranges 
freely over the skin, whilst the female retires with her eggs 
to oblique burrows in the cuticle. These receptacles having 
been broken up by soap and water, sulphur ointment is care- 
fully spread over all the patient's body at bed-time, and 
washed away by a warm bath next morning. Two or three 
applications of this sort are sufficient to cure the disease, and 
if the patient's skin will bear the unguentum sulphuris, one 
smearing with this may be sufficient. The rationale of the 
treatment is, not that sulphur acts as a direct poison to the 
acarus, but that it forms with lard a very tenacious and adhe- 
sive substance which suffocates the insect by blocking up its 
air-pores. [The sulphur ointment should generally be diluted 
with cerate, -J- to f , as it is apt to produce too great irritation.] 

Sulphur is also in great favor as a popular remedy for 
rheumatism, sprinkled on new flannel and applied to the 
painful part, and there is no doubt that some beneficial 
action may thus be caused. Lastly, sulphur makes a useful 
bath in some forms of chronic skin disease. 



Internal Use. 



Physiological Action. 

1. It has been supposed to 
exert a stimulating influence 
on the mucous membranes 
and skin. 



Therapeutical Action. 

1. In virtue of this, it 
used to be occasionally pre- 
scribed in chronic broncliitis 
and phthisis, and also used 
externally in skin diseases. 
To its action on the skin may 
be attributed its undoubted 
power of aiding, — more es- 
pecially in the form of bath, 
— the elimination of lead and 
mercury from the system. 
Sulphur has lately been re- 
commended as the best means 
of preventing mercurial sali- 
vation. 



424 



SULPHUR. 



2. It causes slight increase 
of the peristaltic movements 
of the bowels. 



3. Sulphur has well-marked 
antiseptic properties in con- 
sequence of its destructive 
power over the lower forms 
of vegetable life. 



2. It acts, therefore, as a 
gentle laxative, slightly soft- 
ening the feces, and from 
the mildness of the action it 
is specially useful in piles 
and all irritable conditions 
about the rectum. Its pur- 
gative action is increased by 
its being dissolved and formed 
into a sulphide by the alkali 
of the bile. 

3. Burnt in a room with 
closed doors and windows, it 
is the best way to remove the 
germs of infection from the 
air by fumigation. 



Sulphur is given off from the system principally by the 
bowels, but also by the milk, the sweat, and the skin, in 
the form of sulphuretted hydrogen, and by the urine as a 
sulphate. 

Strong applications of sulphur frequently irritate the skin, 
and bring on troublesome eczema. The disadvantage of sul- 
phur as an aperient, is the offensive odor which the sulphur- 
etted hydrogen communicates to the feces. 

The confection [Br.] is the best purgative form [contain- 
ing sulphur ^iv, and cream of tartar §j? in syrup of orange- 
peel f^iv], in tea- or tablespoonful doses. 

[The sulphites have been recommended by Polli in drachm 
doses for pyasmia and septicaemia, but more extended experi- 
ence declares them to be worthless for this condition. The 
sulphite or the hyposulphite of soda is sometimes given in 
yeasty or sarcinous vomiting to prevent fermentation.] 



[Suppositoria. 

The officinal Suppositories are — 



Suppositoria Acidi Carbolici 
" " Tannici 

" Aloes 

" Assafoeticlse 

" Belladonnse 



Suppositoria Morphia 
" Opii 

" Plumbi 

" Plumbi et Opii.] 



TOBACCO. 425 



[Syrupi. 

The officinal Struts are — 

Syrupus AcaciaB Syrupus Pruni Virginianae 

" Acidi Citrici " Rhei 

" Allii " " Aromaticus 

" Amygdalae " Ros?e Gallicae 

" Aurautii Corticis " Rubi 

" " Floruin " Sarsaparillse Comp. 

" Ferri Iodidi " Scillse 

" Fuscus " " Compositus 

" Ipecacuanhse " Senega? 

" Kramerise " Tolutamis 

" Lactucarii " Zingiberis.] 

" Lirnonis 



TABACUM— TOBACCO. 

[ The commercial dried leaves of Nicotiana Tabacion, U. S. 

Officinal Preparations, U. S. 

Infusum Tabaei (3j to Oj). Dose, f^ij (8. Gm.). 
Oleum Tabaei. Not used internally. 
Unguentum Tabaei. (Watery extract of leaves 5J 
to j§xvj of lard.) 

Vinum Tabaei. Dose, gtt. v to xx (.30 to 1.30 Gm.). 

Antidotes. 

Strychnia and diffusible stimulants may be regarded as 
physiological antidotes to tobacco ; and, after thoroughly 
washing out the stomach, tincture of digitalis may be ex- 
hibited to counteract the depressing influence of the poison 
on the heart, and the tendency to collapse. Respiration 
should be stimulated by ammonia, frictions, and even main- 
tained artificially. Sulphate of strychnia may be given 
hypodermically, and stimulating enemata injected.] 

Effects and Uses. 

Tobacco is now rarely, if ever, used internally in medi- 
cine, on account of its poisonous properties ; but it is a sub- 
stance in such general domestic use, and therefore of so 
great physiological interest, that we must devote some little 
space to considering the results of modern experiment on its 
action. 

3G* 



426 



TOBACCO. 



Local Action. 

Physiological. Therapeutical. 

Tobacco is readily absorbed Tobacco has been used as 
by the skin, and symptoms a local application in prurigo 



of poisoning have followed 
the application of strong infu- 
sions to the unbroken cuticle. 



and other skin diseases, but 
is too readily absorbed to de- 
serve recommendation for this 
purpose. 



Internal Actions. 



1 . Brain and Nervous Sys- 
tem. — The brain seems to be 
little affected, but some ex- 
citement of the spine is an 
early symptom of the poison- 
ous action of the drug, speedily 
followed, however, by mus- 
cular relaxation and paralysis, 
also of spinal origin. 

The sensory nerves are not 
affected, but we find lowering 
of the functional activity of 
the motor nerves. The pupil 
is contracted. 

[Amblyopia, caused "by cen- 
tral scotoma of the retina, is 
noticed from the constant 
use of tobacco, and color- 
blindness is not uncommon in 
smokers. It is claimed that 
these effects are more apt to 
follow from the combined 
action of tobacco and alcohol.] 



1. Before the introduction 
of chloroform, advantage was 
taken of the depressing and 
relaxing influence of tobacco 
on the muscular system to 
employ the enema in stran- 
gulated hernia and disloca- 
tions. Any occasional suc- 
cess, however, was amply 
counterbalanced by the in- 
conveniences and even dan- 
gers which too often resulted ; 
and this application of the 
drug has now fallen into well- 
merited oblivion. 

In consequence of its low- 
ering action on the reflex 
function of the spinal cord, 
it has been proposed as a 
remedy for tetanus and an 
antidote for strychnia, and 
the alkaloid nicotia will be 
found most convenient for 
these purposes. 

The use of tobacco is be- 
lieved to have some injurious 
effect on vision ; and Hutch- 
inson and others have re- 
corded instances of atrophy 
of the optic nerve and total 
blindness thus produced. 



TAMARIND. 



427 



2. Circulation and Respi- 
ration It is not necessary 

for us to go into the elaborate 
and contradictory series of 
experiments made to prove 
the fact that tobacco is a 
powerful depressant of the 
heart's action. The temper- 
ature usually Mis in tobacco- 
poisoning, and death ensues 
from respiratory paralysis. 
[Excessive use of tobacco 
produces functional disorder 
of the heart, which may result 
in hypertrophy, dilatation, 
and organic disease.] 

3. Digestive and Secreting 
Organs. — Tobacco usually 
causes nausea and vomiting, 
as most smokers can testify ; 
but toleration is soon estab- 
lished, and even considerable 
doses then fail to disturb the 
equanimity of the digestive 
organs, save a slightly pur- 
gative action on the bowels. 
It is stated, however, that 
in habitual smokers some 
symptoms of dyspepsia may 
be detected, indicated by 
furred tongue and loss of 
appetite ; and there is also 
some generally diffused, gran- 
ular irritation about the pha- 
rynx. 



2. Tobacco-smoking has 
been known to give relief 
in asthma and chronic bron- 
chitis. 



3. [The post-prandial cigar 
is thought to aid digestion 
by confirmed smokers, and, 
in some cases, increases either 
the peristalsis or secretions of 
the intestine, or both, thus 
acting as a laxative. Small 
doses of the wine of tobacco 
may be added to a laxative 
combination given at night. 



[TAMARINDUS— TAMARIND. 

The preserved fruit of Tamarindus Indica, U. S. 

Tamarinds are laxative, and are used in making a re- 
frigerant drink for the sick. They enter into the Confectio 
Senna?.]] 



428 CANADA TURPENTINE. 

[TAPIOCA— TAPIOCA. 

The fecula of the root of Janipha Manihot (Bot. Mag. 3071), U. S. 

Tapioca, the starch of the Cassava plant, is used like 
arrowroot as an article of diet.] 



TARAXACUM—DANDELION. 

[ The root, gathered in the autumn, of Taraxacum Dens-leonis 
(De CandoUe), U. S. 

Officinal Preparations, U. S, 

Extractum Taraxaci. Dose, gr. xx-xxx (1.30 to 
2. Gm. 

Extractum Taraxaci Fluidum. Dose, f?>j- 
ij (4. to 8. Gm.). 

Infusum Taraxaci (gij to Oj). Dose, fgiv (128. 
Gm.). 

Sueeus Taraxaci. Dose, f5ij-iv (8. to 16. Gm.).] 

Taraxocum is usually prescribed as a matter of routine in 
sluggish liver, and the various forms of dyspepsia depending 
on a supposed deficiency of bile ; but although it may have 
some mild tonic, diuretic, and aperient properties, there is 
not the slightest evidence for asserting that it exerts any 
real influence over the hepatic functions. 

I£. Succi taraxaci f^j ; 

Acidi nitro-muriatici dil. v\ x ; 

Tincturae lupulinae H\, xx ; 

Aquae q. S. ad fgj; 

S. Ter die sumend. 



4 


Gm. 




65 " 


1 


30 " 


32 


(< 



TEREBINTHINA— TURPENTINE. 

[ The concrete oleo-resin obtained from Pinus palusiris, and from other 
species of Pinus, U. S. 

TEREBINTHINA CANADENSIS— CANADA 
TURPENTINE. 

The liquid oleo-resin obtained from Abies balsamea (Lindley, Flor. 
Med), U. S. 

Enters into Ceratum Resinse Compositum, Emplastrum 
Galbani Compositum (of Turpentine) ; and Charta Can- 
tharidis and Collodium Flexile (of Canada Turpentine).] 



OIL OF TURPENTINE. 



429 



[OLEUM TEREBINTHINJE— OIL OF 
TURPENTINE. 

The volatile oil distilled from the turpentine of Pinus palustris and of 
other species of Pinus, U.S. 

Dose of oil of turpentine tt^ x-xx (.65 to 1.30 Gm.), given 
3 or 4 times daily, in typhoid fever, or chronic dysentery ; 
or f3j to f^ ss (4. to 16. Gm.) as a vermifuge. 

Officinal Preparation, U. S. 

Linimentum Terebinthinae. (Resin cerate §xij, 
oil of turpentine ^viij.) Used as a counter-irritant. 

Turpentine enters into Linimentum Cantharadis.] 
Local Action. 



Physiological. 

Turpentine, when applied 
to the skin, causes redness, 
tingling, and irritation, lead- 
ing on to acute inflammation 
and blistering, if not removed 
within a limited period. 



Therapeutical. 

This effect of turpentine 
causes it to be much used as 
a counter-irritant in those 
cases where we wish to re- 
lieve congestion of internal 
organs by driving the blood 
to the surface. Thus, in 
peritonitis, pneumonia, bron- 
chitis, and asthma, it is fre- 
quently employed, either 
sprinkled on hot flannel, or 
in the form of the linimentum 
terebinthinae of the Pharma- 
copoeia. 



Constitutional Actions. 



Physiological. 

1. On the Brain Tur- 
pentine produces, in large 
doses, giddiness, and other 
symptoms somewhat resem- 
bling alcoholic intoxication, 



Therapeutical. 

1. [Turpentine is a valua- 
ble stimulant in low fevers, 
where the kidneys are not 
diseased.] 



430 



OIL OF TURPENTINE. 



and even ending in coma in 
rare instances. 

2. Circulation Turpen- 
tine acts at first as a stimulant 
to the heart, and has un- 
doubted astringent proper- 
ties, partly, no doubt, from 
its coagulating influence on 
the albumen of the tissues, 
but also by causing contrac- 
tion of the smaller vessels. 



3. Digestive and Secreting 
Organs Turpentine is dis- 
tinctly irritating to the ali- 
mentary canal, frequently 
causing vomiting and diar- 
rhoea, and it has the property 
of checking mucous secre- 
tions from the various canals. 

It is also a very certain 
diuretic of the stimulating 
class, but must be used with 
caution, as it is apt to cause 
frequent and painful mictu- 
rition with bloody urine, and 
eventual suppression of the 
secretion [strangury], and 
acute inflammation of the 
kidneys. 



2. As an astringent, tur- 
pentine is valuable in various 
forms of hemorrhage, but 
more especially in that from 
the kidney and in purpura 
hemorrhagica [but is now 
rarely used as a haemostatic, 
oil of erigeron Canadense, 
ergot, and the mineral astrin- 
gents being more reliable, 
and less irritating]. 

3. Turpentine is a valua- 
ble astringent in some forms 
of diarrhoea, and more espe- 
cially that which results from 
the later and ulcerative stage 
of enteric or typhoid fever. 
It is highly recommended in 
the same disease by some 
authorities when abdominal 
pain and distension coincide 
with a raw, clean, dry tongue, 
and in ordinary tympanites 
it makes a good addition to a 
purgative enema. It has been 
recommended by Dr. King 
Chambers as an enema in 
sciatica, where it is supposed 
to act locally on the affected 
nerve, which, at one part of 
its course, lies directly in 
contact with the large intes- 
tine ; and it has long enjoyed 
a well-deserved reputation as 
an anthelmintic in cases of 
tape-worm. 

Turpentine has also been 
given in small doses to check 
the excessive secretion in 
some forms of bronchitis, 
and it may also be of service 



OYSTER-SHELL. 431 

in chronic cystitis, gleet, and 
pyelitis. 

It has also been used in 
iritis with alleged success, 
though it is difficult to see on 
what principle. 

Mode of Elimination. 

Turpentine is rapidly absorbed into the blood, and as 
quickly passes out, principally by the lungs and kidneys, 
imparting to the urine a peculiar violet odor. 

[Old oil of turpentine is considered an efficient antidote 
against phosphorus-poisoning.] 

Dose and Mode of Administration. 



M. 



A few drops of the oil may be given on a lump of sugar, 
in hemorrhage. 

As an anthelmintic, half an ounce may be prescribed 
[combined with an ounce of castor oil, and is very effective 
against round ivorms as well as taeniae.'] 



R. Olei terebinthinse 


m\ 


or 


4 Grn 


Mucilaginis acacia? 


f3YJ 


" 


20; " 


Misturre amygdala?, 








Aqua? laurocerasi [Br.], 


aa f ^ss ; 


it 


16; " 


S. f 5j pro dosi quartis koris. 









[TESTA— OYSTEPv-SHELL. 

The shell of Ostreu edulis, U. S. 
Officinal Preparation, U. S. 
Testa Preparata. Dose, gr. x-xl (.65 to 2. GO Gm.).] 

Prepared oyster-shell, consisting of 98 per cent, of car- 
bonate of calcium, is used in impalpable powder as an antacid 
in dyspepsia. [Castillon's powders consisted of sago, salep, 
tragacanth, each in powder, aa 5j? prepared oyster-shell 3j, 
and some cochineal as a coloring ingredient. A decoction 
of this powder in milk (5j to Oij) may be used freely as an 
article of diet in bowel affections.] 



432 



TRAGACANTH. 



[Tineturae. 

The officinal Tinctures are — 



Tinctura Aconiti Radicis 

" Aloes 

" " et Myrrha? 

" Arnica? 

" Assafcetida? 

" Aurantii 

" Belladonna? 

" Benzoini 
" " Composita 

" Calumba? 

" Cannabis 

" Cantharidis 

" Capsici 

" Cardamomi 
" " Composita 

" Castorei 

" Catechu 

" Cinchona? 
" " Composita 

" Cinnamorui 

" Colchici 

Conii 

" Cubeba? 

" Digitalis 

Ferri Chloridi 

Galla? 

" Gentiana? Composita 

" Guaiaci 
" " Ammoniata 



Tinctura Hellebori 

" Hamuli 

" Hyoscyami 

" Iodinii 
" " Composita 

" Jalapae 

" Kino 

ii Kraineria? 

" Lobelia? 

" Lupulinae 

" Myrrhae 

" Nueis Vomica? 

" Opii 
" " Acetata 

" " Camphorata 

" " Deodorata 

" Quassia? 

" Rhei 
" " et Senna? 

" Sanguinaria? 

Scilla? 

" Serpen taria? 

" Stramonii 

" Tolutana 

" Valerianae 
" " Ammoniata 

" Veratri Viridis 

" Zingiberis.] 



TRAGACANTH A— TRAGACANTH. 

[A gummy exudation from Astragalus verus (Olivier), and from other 
species of Astragalus, U. S. 

Officinal Preparations, U. S. 

Mueilago Tragacanthse, as a vehicle. 

It is the basis of the officinal troches : Trochisci Acidi 
Tannici, Trochisci Ipecacuanha?, Trochisci Potassii Chlo- 
ratis, Trochisci Santonini, and Trochisci Zingiberis.] 

Tragacanth is of service as a vehicle for the suspension 
and division of various powdered drugs. 



SLIPPERY ELM 



433 



[Troehisci. 



The officinal Lozenges are — 



Troehisci Acidi Tannici 

" Greta? 

1 ' Cubeba? 

" Ferri Subcarbonatis 

" Grlycyrrhizae et Opii 

" Ipecacuanha? 

" Magnesia? 



Troehisci Mentha? Piperita? 

" Morph. et Ipecacuanha? 

" Potassii Chloratis 

" Santonini 

" Sodii Bicarbonatis 

" Zingiberis.] 



ULMUS— SLIPPERY-ELM. 

[ The inner bark of Uhnusfulva (Michaux), U. S. 

Officinal Preparation, U. S. 
Mueilago Ulmi. Used externally.] 

Elm bark is probably tonic and astringent, but is rarely 
if ever used, [except as an emollient application in external 
inflammations, such as erysipelas]. 



[Unguenta. 



The officinal Ointments are- 



Unguentum (formerly Unguen 
turn Adipis). 
" Acidi Carbolici 

" Acidi Tannici 

" Antimonii 

" Aqua Rosa? 

" Belladonna? 

" Berizoini 

" Caritbaridis 

" Creasoti 

Galla? 

Hjdrargyri 
" " Amraoiiiati 

" Iodidi Rubri 

" Nitratis 



Unguentum Hydrarg. Oxidi Flavi 
" " " Rubri 

" Iodinii 

" " Compos it urn 

' ■ Mezerei 

" Picis Liquid* 

" Plumbi Carbonatis 

Iodidi 

Potassii Iodidi 
" Stramonii 

" Sulpburis 

" " Iodidi 

Tabaci 

Veratriae 

Zinci Oxidi.] 



434 E Al SINS — V A L E R I A N . 

[UVA PASSA— RAISINS. 

The <hi<(l fruit of Vitis Vinifera, U. S. 

Raisins are laxative, and are used asaflavoring to demul- 
cent beverages. They enter into the Tincture of Rhubarb 
and Senna.] 

UVA URSI— BEARBERRY. 

[ Th leaves of Arcfostaphylos Uva Ursi (Sprengel, Syst. //. 287), U, S. 
Officinal Preparations, U. S. 
Decoctum Uvae Ursi (f'Jj to Oj). Dose, fgiv (128. 

Gin.)- 

Extraetum Uvae Ursi Fluidum. Dose, f 5j (1. 

Gm.).] 

Uva ursi is astringent and The astringency of this 
possibly diuretic. [It is also drug being principally di- 
tonic and antilithic, and is rected to the genito-urinary 

believed to favor uterine con- mucous membrane, it is held 
traction.] by surgeons to be of some 

service in various chronic 
affections of these parts. 

VALERIANA— VALERIAN. 

[The mot of Valeriana officinalis, U. S. 

Dose, in substance, gr. xxx to 5jss (2. to 6. Gin.). 

Officinal Preparations, U. S. 

Extraetum Valerianae. Dose, gr. x-xxx (.65 to 2. 
Gm.). 

Extraetum Valerianae Fluidum. Dose, f 3j (4. 
Gm.). 

Infusum Valerianae (fgss to Oj). Dose, f^ij-iv 
(64. to 128. Gm.). 

Oleum Valerianae. Dose gtt. iv-v (.25 to .30 Gm.). 

Tinetura Valerianae (5 ij to Oj). Dose, fjj-ij (4. 
to 8. Gm.). 

Tinetura Valerianae Ammoniata (3 ij to Oj). 
Dose, i'Sj-ij (L to 8. Gm.). 



VANILLA — WHITE HELLEBORE. 435 

Valerianic Acid. (See page 117.) 
Ammonii Valerianas. ) ^ . •• , n > . , -, 

Quiniaa Valerianas. - • Do ^ ^V^ ( M to ' U 
Zinei Valerianas. ) ^ m ->J 

Effects and Uses. 

Various elaborate investi- The more important thera- 

gations have been made in peutic applications of valerian 

Germany on the physiologi- have not stood the test of 

cal actions of valerian, but time and experience, and its 

they have not much bearing use is now practically re- 

on its practical application, stricted to hysteria and the 

and the drug itself is hardly various nervous conditions 

of sufficient importance to depending thereon. [In 

justify us in devoting much nervous headache, the am- 

time to its consideration, moniated tincture is a reliable 

We may therefore say, gene- resource.] 

rally, that acceleration of the The oil is supposed to be 

action of the heart, mental the active principle. It may 

hallucinations, giddiness, and be used with ether for inhala- 

some digestive derangement tion, in nervous headache. 
are among the principal of 
the symptoms (described most 
fully by Phillips). 

[The salts of valerianic acid are now generally used in the 
place of the preparations of valerian itself. These salts may 
be given in pill or in combination with simple elixir. The 
elixir of valerianate of ammonia is generally kept in the 
shops.] 



[VANILLA— VANILLA. 

The prepared unripe fruit of Vanilla aromatica, U. S. 

Used as a flavoring ingredient in Trochisci Ferri Sub- 
carbonatis, and Trochisci Potassii Chloratis.] 



VERATRUM ALBUM— WHITE HELLEBORE. 

I The rhizome of Veratrum album, U. S.~\ 

White hellebore possesses some of the physiological pro- 
perties of veratrum viride, but much of its energy is ex- 



436 



AMERICAN HELLEBORE. 



pended on the alimentary canal, and violent vomiting and 
purging often follow its use. It is, therefore, now quite dis- 
carded from medical practice. When applied to the nostrils, 
even greatly diluted, it causes intense sneezing. 

Two alkaloids [in addition to veratria] have been dis- 
covered in the root-stalk, one of which has been called jervia, 
and the other veratralbia. 

[For the discussion of the effects of Veratria, see Saba- 
dilla, page 400.] 



VERATRUM VIRIDE— AMERICAN HELLEBORE. 

[ The rhizome of Veratrum viride, U. S. 

Officinal Preparations, XI. S. 

Extractum Veratri Viridis Fluidum. Dose, 
gtt. j-iij (.06 to .20 Gm.). 

Tinetura Veratri Viridis (^viij to Oj). Dose, gtt. 
iij-viij (.20 to .50 Gm.). 

(Dr. Norwood's tincture is of the same strength as the 
officinal' tincture.)] 

Some local action has been observed, of an irritant nature, 
somewhat resembling that of veratria. 



Constitutional Actions. 



Physiological. 

1. Brain and Nervous 
System 1. Green helle- 
bore has no action on the 
brain. 

2. Spinal Cord. — A very 
decidedly depressing effect 
is exerted on the spine, indi- 
cated by extreme muscular 
prostration. 

II. Heart and Circula- 
tion Veratrum viride is 

also a powerful vascular de- 
pressant, the pulse rate being 
lowered, and the arterial ten- 
sion diminished ; these effects 
beins: due both to a direct 



Therapeutical. 



2. [It has recently been 
very highly recommended in 
puerperal eclampsia.^ 



II. Veratrum viride has 
been extensively used in 
America on account of its 
depressing influence on the 
circulation, and it is stated 
that we may get good results 
by prescribing it in the early 



ZING. 



437 



action of the drug on the 
heart muscle and to stimu- 
lation of the cardiac inhibi- 
tory nerves. 



stages of pneumonia and 
other inflammatory condi- 
tions. Little or no English 
experience, however, has yet 
been brought to bear on the 
discussion of this question. 
[The late Prof. Dickson 
prized it very highly in ty- 
phoid fever, administered in 
large doses, even as much as 
forty drops being given, with 
/ the best effects.] 

III. No effect is produced 
on the respiration, but a dis- 
tinct lowering of temperature 
has been observed. 

IV. Digestive and Secret- 
ing Organs Yeratrum vi- 

ride has emetic properties, 
and frequently causes vomit- 
ing ; and purging, also, not 
unfrequently follows its use. 

Two alkaloids exist in veratrum viride, Jervia and 
Veratroida, the main difference between which seems to 
be, that the latter is apparently responsible for the digestive 
disturbances which occasionally results. 



[IV. The nauseating 
depressing effects are 
counteracted by opium 
alcoholic stimulants.] 



and 
best 
and 



[Vina. 



The officinal Wines are- 

Viiuim Aloes 
" Antiinonii 
" Colcliici Radicis 
" Seminis 
" Ergotae 
" Ipecacuanh.se 



Viniim Opii 
" Portense 

Rhei 
" Tabaci 
'" Xericum.] 



ZINCUM— ZINC. 

[Officinal Preparations, U. S. 

Zinei Oxidum. Dose, gr. ij-x (.12 to .65 Gm.). 
Zinei Oxidum Venale. 

Unguentum Zinei Oxidi (1 to ."»). 
37* 



438 zinc. 

Zinei Chloridum. As a caustic and astringent. 

Liquor Zinci Chloridi. (Burnett's Disinfecting Fluid.) 
Zinei Aeetas. 
Zinei Carbonas Pra^cipitata. 

Ceratum Zinci Carbonatis (1 to 5). 
Zinei Sulphas (white vitriol). Dose, as an emetic, 
gr. x-xxx (.65 to 2. Gm.). 

Zinei Valerianas. Dose, gr. i-ij (.06 to .12 Gm.). 

Antidotes. 

The alkalies and alkaline carbonates are the chemical 
antidotes to the salts of zinc. Evacuation of the stomach 
and bowels should be followed by the exhibition of eggs and 
milk. The retching, colicky pains, and diarrhoea, may be 
relieved by morphia hypodermically.J 

Local Actions. 
Physiological. Therapeutical. 

Chloride of zinc is an ex- Chloride of zinc has been 
ceedingly powerful caustic, used as a caustic for the 
and, in weak solution, has as- treatment of cancerous and 
tringent properties. Thesul- other ulcerations, either in 
phate and oxide are also as- strong solution, substance, 
tringent in varying propor- or arrow-shaped masses made 
tions. with flour, and inserted into 

incisions around the base of 
the morbid mass. It has 
turned out to be the principal 
ingredient in all so-called 
cancer curers' nostrums, and 
is employed in legitimate 
surgery as an application to 
wounds from which cancer- 
ous growths have been re- 
moved, and also (in the 
strength of gr. lx ad fjj) 
to the raw surface after ordi- 
nary operations, with the 
view of preventing pyaemia. 
Sulphate of zinc is a 
much-valued astringent lo- 



ZINC. 



439 



tion in conjunctivitis, and 
makes an excellent injection 
in gonorrhoea and leucor- 
rhcea ; and the oxide, either 
in "powder or ointment, is 
one of the most useful appli- 
cations in chronic skin dis- 
ease. [The acetate is used 
for the same purposes as the 
sulphate (gr. \ to \ in rose- 
water 3j).] 



Internal Actions and Uses. 



Physiological. 

1. Action on Nervous Sys- 
tem. — This is probably tonic 
in character, and some as- 
tringent properties may also 
be noted. 



2. On Digestive System. 
— Sulphate of zinc promptly 
and effectually empties the 
stomach, without causing 
much depression or nausea. 

I£. Zinci sulphatis 
Aquse 



Therapeutical. 

1. We can thus explain 
the benefit which sometimes 
results from the use of sul- 
phate of zinc in chorea. 
We here begin with a grain 
and continue in gradually 
increasing doses up to 6 or 
8 grains, tolerance being 
rapidly established, and the 
emetic action of the drug 
avoided. Oxide of zinc, in 
doses of from 1 to 5 grains, 
is an excellent remedy in the 
night-sweats of phthisis, and 
it is also a valuable aid to 
treatment in the diarrhoea of 
children. 

2. It is therefore our most 
reliable direct emetic, invalu- 
able in cases of poisoning, in 
doses of from 20 to 30 grains; 



gr. xxx 

f^iij ; 



2 ! 

256 



Gm. 



Fiat haustus emeticus statim sumendus. 



fy. Zinci chloridi 
Aqua? rosse 



gr- J 
f giv ; 



106 Gh 



128 



M. 



M. 



A good injection in gonorrluca. 



440 



GINGER. 



R. Zinci oxidi 5'.] ! 

Grlycerinae i'3ij ; 

Liquor plumbi subacetatis f 3iss 

Aqua? calcis q. s. ad f §vj. 

Fiat lotio. 

Useful in impetigo. 



81 Gi 



6 

192 



M. 



150! Gi 



R. Zinci Valerianatis gr. xxiv ; or 

Confectionis rosse q. s. 

Fiat massa in pilulas duodecim dividenda. Deaurentur 
pilulae. 

Nervine tonic. 



ZINGIBER— GINGER. 

[The rhizome of Zingiber officinale (Roscoe, Trans. Linn. Sue.), U. S. 

Dose, in substance, gr. x-xv (.65 to 1. Gin.). 

Officinal Preparations, U. S. 

Extraetum Zingiberis Fluidum. Dose, tti^x-xx 
(.65 to 1.30 Gin.) 

Infusum Zingiberis (^ss to Oj). Dose, f gij-iv (64. 
to 128. Gin.). 

Oleo-resina Zingiberis. Dose, rr^ss— ij (.03 to .12 
Gm.). 

Syrupus Zingiberis. As a vehicle. 

Tinetura Zingiberis (§iv to Oj). Dose, f 3ss— j (2. 
to 4. Gm.). 

Troehisei Zingiberis (each containing nijj of the 
tincture). 

Also enters into Acidum Sulphuricum Aromaticum, Pilula3 
ScillaB Composite, Pulvis Aromaticus, Pulvis Rhei Com- 
positus, and Vinuin Aloes.] 

Ginger is an agreeable stimulant and carminative. 



Having now completed the study of the various articles 
contained in the national Pharmacopoeia, we shall proceed 
to give a brief resume of the properties of the most useful 
among those drugs which have not yet received full official 
sanction. Among these will be found some very important 
remedies, also plants of great physiological interest, whose 
active medicinal powers have not yet been fully tested in 
practical medicine, and whose investigation opens up a valu- 
able field for clinical observation. 






REMEDIES IN FREQUENT USE, BUT NOT 
INCLUDED IN THE PRIMARY LIST OF THE 
MATERIA MEDICA, U. S. P. 



[ACIDUM BORACICUM— BORACIC ACID. 

Boracic acid may be obtained by the decomposition ot 
borax by sulphuric acid. It occurs in white, shining, scaly 
crystals, with no smell, and a feeble acid taste. Dissolved 
in alcohol, it imparts a characteristic green tinge to its flame ; 
it is soluble, also, though to a less extent, in water (20 parts 
cold, or in 3 of hot). Borax, but to a higher degree, boracic 
acid, has decided antiseptic power, arresting fermentation 
and putrefaction by destroying the organic ferments upon 
which their processes depend.] This is an excellent anti- 
septic application to superficial granulating surfaces, used as 
a lotion, 40 per cent, saturating water, or as boracic lint, 
made by soaking lint in a hot 30 per cent, solution, and 
allowing it to dry, or an ointment : Boracic acid and white 
wax, 20 parts each ; almond oil and paraffine, 20 parts 
each. Glycerine is also an excellent solvent. Free appli- 
cation of the saturated solution is the best remedy for the 
fetid perspiration of the feet which often causes so much 
annoyance. [In the aphthous sore-mouth of children, in 
which it acts in a similar manner, borax and sugar has long 
been a favorite remedy ; and a solution of borax forms a 
common wash for use in disorders of the hairy scalp, and in 
scaly eruptions. In pruritus, tinea circinata, pityriasis 
versicolor, etc., boracic acid solutions are of much service. 

Boracic acid, finely levigated, has been used of late years 
with great success, insufflated into the auditory canal, in 
cases of chronic suppurative discharges from the ear. It 
appears to be perfectly free from irritation, and quickly re- 
duces the offensive character of the discharge as well as its 



442 



SALICYLIC ACTD. 



quantity. Boracic acid has also been used in general sur- 
gery as a dressing for wounds, and Mr. Lister employs it to 
a considerable extent in his system of dressings. 

Boracic acid and borax have been used in lozenges for 
public speakers in order to prevent hoarseness, but are 
seldom employed internally in any other form, although the 
latter has been highly recommended in the uric acid diathe- 
sis in doses of thirty or forty grains.] 



ACIDUM SALICYLICUM— SALICYLIC ACID. 

f Sodii Salieylas. Dose, gr. xx to 3j (1-30 to 4. Gm.) 
Ammonii Salieylas. Dose, the same. 
Cinehonidia^ Salieylas. 
Chinolin Salieylas. 1 ] 



Local Actions. 



Physiological. 

Salicylic acid is an excel- 
lent antiseptic, delaying pu- 
trefaction and preventing de- 
composition. 



Therapeutical. 

Being less irritant than 
carbolic acid, it has been 
proposed as a substitute for 
that substance in carrying 
out Lister's antiseptic sys- 
tem. It has also been rec- 
ommended as a good lotion 
to raw surfaces ; but Callen- 
der has shown that it not 
only tends to irritate the 
wounds, but frequently brings 
out a crop of irritable vesicles 
in their neighborhood. [It 
has been used as an applica- 
tion in diphtheritic croup, in 
powder or solution.] 



Constitutional Action. 



Salicylic acid is an anti- 
septic and antipyretic, rapidly 
reducing temperature in fever- 



Salicylic acid is now uni- 
versally allowed to be a most 
efficient remedy in acute 



See page 237 for Chinolin. 



SALICYLIC ACID. 



443 



ish conditions, although, in a 
state of health, the drug seems 
to be without influence on the 
body heat. Some headache, 
giddiness, and ringing in the 
ears have been observed, but 
the cardiac and respiratory 
functions are not sensibly 
affected. 

In poisonous doses, slow- 
ing of the breathing and con- 
es o 

vulsive attacks, from diminu- 
tion of the excitability of the 
vagus, have been observed. 
Nausea, burning in the throat, 
vomiting, and stomach irrita- 
tion have occasionally been 
noticed to follow the use of 
the acid ; and albuminuria 
with almost total suppression 
of urine, and occasionally 
hematuria are more rarely 
noted among its effects ; the 
most usual action, however, 
on the kidneys being diuretic, 
with slight increase of urea 
and uric acid. 



rheumatism, very rapidly re- 
ducing temperature, relieving 
pain, and, in fact, cutting 
short the disease. By short- 
ening the duration of the 
joint inflammation, it natu- 
rally limits the tendency to 
cardiac complications; but it 
seems to have no power of 
directly reducing the liability 
to this accident, nor influence 
over developed pericarditis, 
or in averting or arresting 
conditions of hyperpyrexia. 
In an ordinary case of acute 
articular rheumatism, we may 
count upon cutting short the 
disease in two or three days, 
the pain going first and then 
the fever. It is well to con- 
tinue the drug for 10 or 15 
days after the apparent cure, 
in order to prevent relapses, 
and the anaemia so often fol- 
lowing other modes of treat- 
ment is not met with under 
this. It is of less service in 
chronic rheumatism or gout, 
it is useless in ague, and al- 
though in typhoid fever the 
temperature may go down, no 
influence is exerted on the 
duration of the disease. 



Mode of Elimination. 

Elimination is effected by the urine, beginning in 10 
minutes and being completed in from 24 to 48 hours, and 
the acid seizing glycocol from the liver and other organs 
becomes converted into salicyluric acid, thus resembling the 
conversion of benzoic into hippuric acid. Probably a little 
is also given off by the sweat and saliva. The soda salt is 
rapidly transformed into the original acid by the carbonic 
acid of the blood. 



444 



SALICYLIC ACID. 



Dose and Mode of Administration. 

"We may give salicylic acid in 20-grain doses, repeated 
hourly for six hours on two successive days and continued at 
shorter intervals if the disease resists 48 hours' medication. 
As much as 280 grains have been given without injury 
within 12 hours, but it is always well to avoid very large 
doses, which are very apt to cause irritation and discomfort. 

Salicylic acid, being irritating and very insoluble, has been 
now almost entirely displaced by the salicylate of soda, which 
is freely miscible with water and is readily absorbed ; the 
dose being gr. xx to 5j (1-30 to 4. Gm.), being generally 
administered in the smaller dose every hour until a drachm 
has been given daily. 

Dangers from Salicylic Acid. 

[Several instances have occurred in which this agent has 
unexpectedly produced disagreeable consequences. Dr. 
Watelet communicated a paper to a late number of the 
Bull, de Therapie on this subject, in which the details are 
given of two cases of rheumatism treated by salicylate of 
soda, one of which was followed by gangrene of the lower 
extremities, and both by cystitis, obstinate constipation, and 
coldness of the extremities. 1 

Salicylic acid has a strong affinity for lime, and it is 
thought that its administration, if long continued, may inju- 
riously affect the bones and the teeth. Whether this tech- 
nical objection also exists against it when given in combina- 
tion with alkalies, is not clear, but in this form it is certainly 
safer, and these salts are now generally used in preference 
to the acid itself.] 

Since these alkaline salts have come into general use, we 
have heard much less of the uncomfortable effects occasion- 
ally caused by the acid, and some of which, at all events, 
were due to impure preparations containing carbolic or 
cresylic acid. But, in addition to the peculiarities men- 
tioned above, careful observers have described urticaria and 
irritable erythematous and vesicular, cutaneous affections and 
sore throat, with a species of quiet delirium and feverish 
symptoms, and we are specially warned to beware of its use 



Dublin Press and Circular. 



NITRITE OF AMYL. 445 

in kidney disease. As a general rule, however, the soda 
salt may be freely prescribed without the anticipation of any 
of these undesirable results. 

Salicylic acid is very insoluble, and it is difficult to find a 
ready medium for its administration. Messrs. Savory and 
Moore have devised a very elegant granular, effervescing 
preparation, or we may use the salicylate of sodium or 
ammonium. The following are nood formuhe : — 



M. 



$. Acidi salicylici 


3j; 


or 


4 


G111. 


Olei amygdalae expressi 


f3v; 


c t 


20 


" 


Pulv. acacia? 


5i.iss ; 


a 


10 


a 


Syr u pi ainydalae 


t'.^vj ; 


" 


24 


it 


Aquae aurantii iiores q. s 


;. ad fgiij ; 


it 


96 


" 


S. Capiat f 3j pro dosi. 








For children. 








Or, 








$. Acidi salicylici 


3j; 


or 


4j Gin. 


Sp. rect. 


f oijss ; 


( t 


101 


Dissolve. 











Potassii citratis f 3i ; . or 4' " 

Syrupi aurantii f 3 i.j ; " 8 " 

Aqua? f5iijss; " 10; " 

S. Mix tlie two solutions and filter, and then dilute with water 
to taste. 

[The following is used by Da Costa quite extensively in 
acute rheumatism : — 

$. Sodii salicylatis gr. xx ; or 1 30 dm, 

Glycerine JT^xv; " 1 " 

ispt. Lavandulae comp. rqvijss ; " 50 " • 

Aquae q.*s. ad^ss; " 16 " M. 

Fiat haustus quartis horis sumendus."] 



AMYL NITRIS— NITRITE OF AMYL. 

[Dose by inhalation, gtt. iij-v (.20 to .30 Gm.).] 

Local Action. 

Nitrite of amyl is not possessed of any local irritant or 
sedative properties. 
38 



446 



AMYL NITRIS. 



Internal Actions. 



Physiological. 

1. Nervous System 1. 

On Brain. — No special effect 
is produced on this organ 
beyond that resulting from 
dilatation of the cerebral 
vessels, and consisting of a 
sensation of fulness and op- 
pression in the head. Oph- 
thalmoscopic examination lias 
proved the retina to be deep- 
ly congested during the in- 
halation of nitrite of amyl. 
Epileptics are observed to be 
unusually susceptible to its 
action. Crichton Browne 
has observed yawning and 
other movements suggesting 
a specific action on the motor 
centres of the mouth. 

2. On Spinal Cord A 

distinct lowering of reflex ir- 
ritability has been observed. 



II. Vascular System.-^l. 
On Heart After a brief in- 
halation of this drug, the 
action of the heart becomes 
excessively rapid, the face 
flushes, and a violent throb- 
bing in all the arteries is ex- 
perienced, with well-marked 
giddiness ; and if its admin- 
istration is pushed up to 
poisonous limits, there is 
much weakening of the car- 
diac pulsations. 



Therapeutical. 

I — 1. It has been recom- 
mended as a remedy for epi- 
lepsy, in virtue of its dilating 
powers releasing the vessels 
of the brain from that condi- 
tion of partial spasm which 
is said to be the cause of the 
disease. When given during 
the fit, it fails ; but in the 
hands of Crichton Browne, 
confirmed by Weir Mitchell 
and others, it has been suc- 
cessful when given before the 
paroxysm, when a distinct 
aura is felt and pallor of the 
face observed. It is also of 
great service in that perilous 
condition known as the status 
epilepticus. 

2. It has been theoreti- 
cally recommended in cases 
of tetanus and strychnia-poi- 
soning, and in neuralgia its 
inhalation has apparently 
been followed by relief. 

II 1. The nitrite of amyl 

has been proposed as an an- 
tidote in chloroform-poison- 
ing, and as a remedy for the 
peculiar heats and flushes 
met with in women about 
the menopause. 



AMYL NITRIS. 



447 



2. The effect on the arte- 
rial system is one of marked 
dilatation, the vessels enlarg- 
ing, as proved not only by 
general flushing, but by con- 
gestion of the retina, and by 
the free flow of blood from 
cupped surfaces which had 
previously yielded only a few 
drops. The arterial tension 
becomes much lowered, and 
this enlargement of the cali- 
bre of the vessels has been 
proved to depend on a direct 
action of the drug on the mus- 
cular coats of the arteries, 
and not on any intervention 
of the vaso-motor system. 

It has also been proved 
that oxidation is diminished, 
that the haemoglobin of the 
blood is checked in its func- 
tion of absorbing and giving 
up oxygen, and that, previous 
to death, the color of the arte- 
rial and venous blood becomes 
almost precisely alike. 



2. In consequence of this 
dilating effect on the vessels, 
amyl has been most success- 
fully used in angina pectoris. 
The essential condition here 
is supposed to be one of 
spasmodic contraction of the 
smaller pulmonary and sys- 
temic vessels, against which 
the heart, generally weaken- 
ed, as it is in this disease, by 
mal-nutrition of its muscular 
structures, finds itself unable 
to cope, and hence the agoniz- 
ing distress. Inhalation of 
the drug releases the spasm, 
and so gives ease ; and this 
result follows whether there 
be actual valvular disease or 
not. 

This explanation of Brim- 
ton, who had the merit of 
first using the drug, has been 
disputed of late, Dr. George 
Johnson holding that the rise 
of arterial tension in angina 
pectoris is not the primary 
cause of that agony, but is 
merely a secondary reflex re- 
sult, and that the remedy 
acts purely in virtue of its 
anti-neuralgic virtues, seeing 
that curative powers are 
equally manifested when face 
flushing already exists. 

Brunton's views, however, 
would seem most in accord- 
ance with the facts observed, 
but, whichever side is right, 
there can be no doubt about 
the accuracy of the evidence 
brought forward in favor of 



448 



AMYL NITRT 



III. On Respiration and 
Temperature. — During the 
early stage of amyl inhalation 
the respiration is hurried, but 
when the administration is 
further pushed the breathing 
becomes slower, and finally 
extinguished, from the arrest 
of the corpuscular function 
noted above, and from a para- 
lyzing effect on the respira- 
tory nervous centre. The 
temperature tends to fall, 
from the diminution in the 
process of oxidation. 

IV. On the Digestive Sys- 
tem. — The presence of sugar 
in the urine has been ob- 
served during amyl inhala- 
tion, this being probably due 
to dilatation of the hepatic 
vessels. 



the clinical superiority of this 
over any other treatment. 

III. Amyl has been suc- 
cessfully used during the pa- 
roxysm of spasmodic asthma, 
acting, no doubt, by relaxing 
the muscular walls of the 
bronchial tubes, and it has 
also been recommended as an 
efficient remedy for whoop- 
ing-cough, but my own expe- 
rience does not bear this out. 



IV. Amyl has been theo- 
retically recommended in 
cholera, but there is no spe- 
cial evidence in its favor. 



Amyl is now known to act more speedily and effectually 
when inhaled than when taken by the mouth, and from 2 to 
5 drops placed on a handkerchief are cautiously drawn into 
the lungs until the characteristic flushing is produced. 

No special accidents are recorded as having arisen from 
its use ; but the caution seems a reasonable one, not to re- 
commend it rashly to old persons with brittle or calcareous 
arteries, as the sudden alteration of calibre might be attended 
with danger. Possibly also it might be advisable not to 
recommend it to very plethoric patients, whose brains are 
already fully filled with blood. As it keeps badly, we must 
be very careful to procure it quite fresh, and not expose it to 
sunlight. 

Anaemic patients seem to be specially tolerant of its use. 

(For Nitro-Glyeerine, see page 464.) 



BETEL NUT — GOLD. 



449 



ARECA— [BETEL NUT, Ph. B] 

This nut possesses some astringent properties, and has 
been used with success as an anthelmintic. 



[AURUM— GOLD. 

Preparations. 



Dose, gr. ¥ V- T V (.0015-006 Gm.) 



Auri Chloridum 

"f, (.003-.015 Gm.) 

Poisonous Effects. 

The effects of the chloride of gold resemble those of the 
corrosive chloride of mercury ; in overdoses corrosive poison- 
ing is produced ; the symptoms closely assimilating those of 



Physiological Effects. 

Digestive Tract. — In over- 
doses gastro-enteritis is set 
up; in minute continued doses, 
the gold salts act as stimu- 
lants to the glandular struc- 
tures of the stomach and 
liver. 



Circulation Like mer- 
cury, the chloride of gold re- 
duces the oxydizing power of 
the red blood cells, and in- 
creases tissue waste. In small 
doses it stimulates the func- 
tions of nutrition, and in- 
creases assimilation. 

Nervous System In small 

doses the mental functions 
are cmickened (Bartholow), 
but upon the spinal cord es- 
pecially are its effects seen 
to be those of a decided 
stimulant. 

38* 



Therapeutical. 

In dyspepsia, gold is use- 
ful in the same class of cases 
as are benefited by the nitrate 
of silver. In the early stages 
of cirrhosis of the liver the 
chloride of gold and sodium 
is one of the most efficient 
remedies we possess. (Bartho- 
low.) 

In fibroid disease of other 
organs, such as the kidney, 
it is useful, especially in that 
form of Bright's disease cha- 
racterized by a large amount 
ot pale urine, containing but a 
small amount of albumen. 



In premature senility or 
decay of the mental powers, 
gold may be cautiously used 
with benefit ; also in the dif- 
ferent forms of sclerosis of 
the spinal cord in its early 



450 AZEDARACH — KOUSSO. 

Sexual System — Thegeni- Tn the treatment of defec- 
ts! organs are stimulated tive menstruation, and simi- 
through an action upon the lar disorders dependent upon 
spinal cord. want of sufficient innervation, 

the gold salts have gained 
some reputation.] 



[AZEDARACH— AZEDARACH. 

The baric of the root of Melia Azedarach, US. Secondary. 

The bead tree, or Pride of China, is largely used in the 
Southern States as an anthelmintic, resembling spigelia in 
its effects. The decoction (^ij to Oij boiled to Oj) is gen- 
erally employed ; the dose to a child being a tablespoonful 
frequently repeated, until it purges]. 



BEL^E FRUCTUS—INDIAN BAEL [Ph. B.] 

Indian bael, containing tannin, has astringent properties, 
and has been highly praised as an effectual cure for the more 
chronic forms of dysentery. Only partial confirmation is 
given by home experience to the evidence furnished from 
abroad; but this may be explained not only by the limited 
opportunities of testing its efficacy in this country, but be- 
cause the drug is probably much more active when used in 
a perfectly fresh state. 



BRAYERA^KOUSSO. 

[The floicers and unripe fruit of Brayera anthehnintica, U. S. 
Secondary.] 

Effects. 

Physiological. Therapeutical. 

The action of kousso is It is therefore occasionally 

poisonous to the tape-worm, used as an anthelmintic, and 

without exerting any irritat- with moderately good effect 

ing or purgative effect. ["Of when given on an empty 

all the remedies for tape- stomach, according to the 

worm none is more efficient rules generally laid down. 
or certain." (StiKe.)] 



BllOMIDE OF ETHYL. 451 

Mode of Administration, etc. 

It is well not to use the officinal tincture [Br.], but to get 
the fresh flowers, boiling about half an ounce in three or four 
ounces of water, adding a little lemon-peel, and directing 
the patient to swallow the whole draught, dregs and all. A 
little vomiting sometimes follows, but is seldom troublesome. 
[A brisk cathartic should follow in three or four hours.] 



BROMIDE OF ETHYL. 

(Ilydrobromic Ether.') 

ETHIDENE DICHLORIDE. 

(Ethylidene Chloride, Chloride of Ethyl.) 

Ethyl bromide has been much praised as an anaesthetic, 
because it is said not to depress the respiration and circula- 
tion, or to cause vomiting, but several deaths have occurred, 
and it is therefore probably an unsafe agent. 

[If pure bromide of ethyl be used, and ordinary care be 
exercised in administering it, the bromide of ethyl is, as re- 
gards safety, somewhere between chloroform and ether. . Dr. 
Levis has used it in many operations without any accident. 
It is pleasant, efficient, and requires such a small amount as 
to make it scarcely more expensive than ether.] 

Ethidene dichloride has been used as an anaesthetic by 
Clover in 1877 cases with one death. He prefers to make 
the patient nearly unconscious by nitrous oxide gas, and 
then add the vapor of ethidene, the resulting sleep being 
quiet and rapidly produced, stertor with dilatation of pupils 
showing when enough has been given. Vomiting is neither 
so frequent nor distressing as when chloroform has been 
given, but there is a tendency to cardiac depression. 

The Glasgow committee of the British Medical Associa- 
tion report that, like chloroform, it reduces the blood press- 
ure, but in less degree and in regular gradations, without the 
unexpected and apparently capricious depression sometimes 
caused by the latter drug. It is therefore (theoretically at 
least) much safer. 



452 COCCULUS INDICUS. 



CASCA BAEK. 

The baric of Erythrophlceum Guineense, generally called Casca, Cassa, or 
Sassy bark. 1 

This is the ordeal bark of Angola. If the victim vomits 
he is acquitted, if it causes purging he is put to death. In 
an examination into its physiological action by T. Lauder 
Brunton, M.D., F.R.S., and Walter Pye, Esq., fifty-four 
experiments were tried on various animals, and it was found 
to uniformly cause vomiting, weakness, and finally death dur- 
ing a convulsion. 

The purgation is probably due to a local action, as it never 
follows subcutaneous injection. The intestinal secretion is 
not increased ; respiration is accelerated from stimulation 
of pulmonary branches of vagus, and not from action on 
respiratory centre. On the circulation a primary slowing is 
caused from stimulation of the vagi, as it ceases after section 
of these nerves ; and, a secondary quickening, by paralysis 
of the ends of the vagus in the heart, thus resembling the 
action of digitalis. The arterioles contract [either directly 
or] from nervous action, the blood-pressure rises, and the 
secretion of urine is increased. 

Powdered casca is a sternutatory, 

Chinolin. (See page 237.) 



[COCCULUS INDICUS FISH-BERRIES. 

The fruit of Anamirta Cocculus ( Wight and Am). 

Pierotoxin (not an alkaloid, supposed by Bouillay to 
be an acid, and named by him Picrotoxic acid). Dose, gr. 
gL (.001 Gm.). 

The active principles are (in the pericarp) menispermia, 
and paramenispermia, hypo-picrotoxic acid, resin, fat, and 
gum, and (in the seed) pierotoxin and anamirtin, or coc- 
culin. 

Treatment of Poisoning. 

Empty stomach, bowels, and bladder, and give stimulants, 
ammonia or ether by inhalation ; and administer bromide of 
potassium.] 

1 See Phil. Trans, of Royal Soc, vol. 107, part 2, rev. ed., 1870. 



WOORARA. 



453 



Physiological Effects. 

Cocculus indicus is poison- 
ous to lower forms of animal 
and vegetable life. 



In man gastro-intestinal 
irritation, congestion of brain, 
strabismus, vomiting, col- 
lapse, and great depression 
of the functions of the spinal 
cord. Picrotoxin differs from 
strychnia in producing alter- 
nate clonic and tonic convul- 
sions, but does not exalt the 
functions of the spinal cord as 
strychnia does. 

It is asserted that, in 
medicinal doses, picrotoxin 
acts like a bitter upon the 
stomach. Upon the spinal 
cord it acts like the combina- 
tion of strychnia with bella- 
donna. It also affects the 
cerebral functions, producing 
stupefaction and delirium ; 
in dogs convulsions are pro- 
duced. 



Therapeutical Effects. 

A solution or ointment of 
cocculus indicus is used to 
destroy lice. It is fraudu- 
lently added to malt liquors 
to stop fermentation, and in- 
crease the bitter taste. 

It is applicable to states of 
the stomach characterized by 
depression, and in paralytic 
conditions of the bowel ; and 
to certain cases of epilepsy, 
in which there is anemia and 
feebleness. In paralysis it is 
less useful than strychnia. 
In chorea, in tremors of alco- 
holism, and similar nervous 
functional disorders, picro- 
toxin may be efficient. Mur- 
rell and Da Costa recommend 
it also in the treatment of 
night-sweats. 

As it has a special effect 
upon the alimentary tract, 
cocculus indicus maybe used 
as a bitter tonic in cases of 
constipation due to torpor of 
the intestinal walls and in 
certain cases of indigestion. 



[CURARE— WOORARA. 

South American arrow-poison. 

Dose, gr. T V (.006 Gm.). 

This is a watery extract of several plants, prominent 
among which are two belonging to the species of strychnos 
and cocculus (probably Strychnos Castelnce, Wed., and Coc- 
culus toxiferus, Wed.), and a variety of pepper. It has the 
consistence of thick paste, becoming brittle on drying; is 



454 



WOORARA. 



blackish-brown in color, and has a bitter taste. It is prob- 
able that its composition varies in different localities. 

Local Effects. 
Physiological. Therapeutical. 

Curare is an irritant to de- It is only applied to wounds 

nuded surfaces, causing pain for its 
and inflammation. ence. 



constitutional influ- 



CONSTITUTIOXAL EFFECTS. 



1. Nervous System. — The 
mind remains clear. The 
inferior extremities are first 
and chiefly affected. " It 
seems probable, however, that 
the primary operation of 
woorara is upon the termina- 
tions of the nerves, and not 
on their central origin." 
(Stille'.) 1 

2. Muscular System.— When 
injected into the blood, or hy- 
podermically, curare causes 
general muscular paralysis, 
first affecting the inferior ex 
tremities, but ultimately in- 
volves all the muscles, in- 
cluding those of respiration. 
A large dose causes death by 
paralysis of respiration and 
asphyxia, but the heart con- 
tinues beating after the 
breathing ceases, and animals 
may be restored by artificial 
respiration. 

It is apt to cause ptosis in 
man, and mydriasis and di- 
plopia may occur. 



1. In epilepsy and chorea, 
curare has been tried and 
found to be useless. 



2. This agent has been em- 
ployed in almost all forms of 
muscular spasm, but it is in 
tetanus that it has achieved 
its best results. It is certain 
that it reduces the muscular 
contractions and saves the 
patient from the consequent 
exhaustion. It is reported 
to have cured 13 out of .33 
cases of tetanus, and deserves 
further trial. 

In hydrophobia it also ex- 
erts a good effect by relieving 
the violence of the convul- 
sions and reducing their fre- 
quency. In three cases it 
has been thought to have 
cured patients afflicted with 
rabies canina. 



1 The National Dispensatory, Philadelphia, 1879, p. 482. 



TURMERIC — DUBOISIA. 455 

3. Upon Secretion When 3. As it is believed that if 

taken by the mouth, curare any abrasion or ulcer exist 

is eliminated by the secre- in the stomach the drug may 

tions nearly as rapidly as ab- exhibit its toxic effects, its 

sorbed, so that it is almost internal use is not considered 

innocuous in this way, simply advisable in any considerable 

acting as a diuretic and dia- dose. 
phoretic. 

Administration, Dose, etc. 

Curare is best exhibited hypodermically, in order to 
insure exactness of administration. A solution in distilled 
water (one part in one hundred) is the most available form, 
but it should be freshly prepared. Ten minims of this solu- 
tion would be the ordinary dose, to be carefully repeated 
until its characteristic effects on the muscular system are 
observed. 

What has been termed the sulphate of curarin has been 
used in doses of one-tenth that of the extract.] 



CURCUMA—TURMERIC. 

[The rhizome of Curcuma longa, U. S. Secondary.'] 

Turmeric is not used in medicine. It forms the coloring 
ingredient in curries, and the theory has recently been 
broached that the yellowish tint so often observed on the 
skin of Anglo-Indians results from the absorption of the pig- 
ment of this substance. [Bibulous paper saturated with the 
tincture and dried, is used as a test for alkalies, which turn 
it brownish-red.] 



DUBOISIA. 

It causes dryness of the throat, dilatation of pupil, with 
dimnessof vision, cephalalgia, vertigo, and drowsiness. The 
pulse and respiration are quickened, and a reddish eruption 
sometimes breaks out on the skin. It may be topically ap- 
plied to dilate the pupil in place of atropia, or by subcuta- 
neous injection, in dose of 1 milligram, to check exhaustive 
sweating. 



456 WHEAT FLOUR. 



ETHYLATE OF SODIUM. 

The application of this substance by a camel-hair brush is 
said by Richardson to be rapidly curative of naevus, lupus, 
warts, etc., and, in the form of spray, of ozaena and nasal- 
polypus. 



EUCALYPTUS GLOBULUS [Ph. B.]. 

Blue Gum- Tree of Tasmania. 

Oleum Eucalypti Foliorum (Volatile oil of Euca- 
lyptus leaves). Dose, r\ ij-x. [.12 to .65 Gm.] 

Eucalyptus is an excellent antiseptic, proving rapidly de- 
structive to infusoria, and being free from the toxic and locally 
irritant effects of carbolic acid, it is not improbable that it 
may at some future time partially supersede that drug. [It 
may, therefore, prove useful in sarcinovs vomiting. The 
tincture and infusion have both been used as applications to 
foul ulcers.] 

It paralyzes the spinal cord and medulla, a period of pre- 
liminary excitement rapidly giving way to profound muscular 
weakness, loss of reflex activity, and finally death from re- 
spiratory failure. 

The pulse loses in force, the temperature is lowered, and 
the excretion of urea is increased. 

As regards the therapeutics of the drug, it appears to have 
been used with success as an antiperiodic. There seems 
to be no doubt that, the presence of the tree in large num- 
bers deprives malarious districts of much of their virulence. 

It has also been recommended in bronchitis and asthma, 
and acts well by inhalation in various pulmonary diseases. 

Dose of the tincture, f5ss to 15 'j- Lister says that its 
use as an antiseptic is aided by dammar varnish which holds 
the oil most readily in combination, and prevents its too rapid 
evaporation. [The fluid extract may also be used, but the 
oil is the best preparation.] 



FARINA TRITICI— WHEAT FLOUR. 

Flour is only of dietetic importance. Bread-crumb (Mica 
panis) is used as a vehicle for pills. 



PURIFIED OX-BILE — GOA POWDER. 



457 



FEL BOVINUM PURIFICATUM— PURIFIED 
OX-BILE [Ph. B.]. 



Pile is well known to act 
a- a laxative, to aid the di- 
gestion of the fatty and amy- 
laceous constituents of our 
diet, and to prevent the de- 
composition of food within 
the intestines, with consequent 
flatus and digestive disturb- 
ance. 



It has, therefore, been sup- 
posed that when a deficiency 
of bile is suspected, we may 
hope to derive advantage 
from ox-gall administered in 
gelatine capsules, so that its 
action may be deferred until 
it reaches the small intes- 
tines. In some forms of dys- 
pepsia and in chronic diar- 
rhoea it is said to be a useful 
remedy, but little clinical evi- 
dence on this point can be 
adduced. 



FUCHSINE. 

Fuchsine in doses of gr. 1\ to gr. 3, thrice a day, has been 
found beneficial in chronic albuminuria with oedema. 

[A weak solution confined between two glasses and placed 
in a spectacle frame, is said to improve certain cases of color 
blindness where the defect is physical rather than physiolo- 
gical.] 



GOA POWDER— [ARAROB A]. 

Has been extensively used in the East, recommended by 
Sir Joseph Fayrer in cases of ringworm and psoriasis. We 
may dissolve a scruple in an ounce of hot lard to make an 
ointment. 

Prof. Attwood having discovered that chrysophanic acid 
is the principal ingredient of Goa powder, Mr. Balmanno 
Scpiire has proved the efficacy of this substance in the same 
class of cases, making an ointment also with hot lard (in the 
proportion of gr. xv to xxx to the ounce). 

There is no doubt as I have amply verified by my own ex- 
perience, that chrysophanic acid, although not the infallible 
specific it was originally supposed to be, is a very useful 
3'J 



458 INGLUVIN — JABORANDI. 

remedy in psoriasis, and the various forms of ringworm. 
Its drawbacks are — 

1st. The irritation it often excites. This may either be 
in the form of a papular eruption, or of an inflammatory con- 
dition closely allied to erysipelas, frequently spreading over 
the head and face, and attended by most distressing tingling 
and itching. 

2d. The peculiar purplish discoloration of the skin which 
it causes, and which is only removed by the free desquama- 
tion of the cuticle which invariably follows. 

3d. The way in which it stains linen, the discoloration, 
however, disappearing after the use of bleaching-powder. 

Mr. Ashburton Thompson 1 has pointed out that chryso- 
phanic acid is an emetic purge of great efficiency, acting 
rapidly, and without much depression. 



INGLUVIN. 

Ingluvin is said to be useful in atonic dyspepsia, ten grains 
of the powder being sprinkled on bread, and taken after 
meals. It has also been recommended in the vomiting of 
pregnancy. 



JABORANDI. 

[Dose of the drug, gr. x to 3j (»65 to 4. Gm.).] 

Preparations (not Officinal). 

Inooarpla Murias,} * * to H 01 to - 03Gl " >■ 

Elixir Jaborandis (gr. x to 3j). Dose 3j to iv (or 
4. to 16. Gm.). 

Extractum Jaborandis fiuidum. Dose m^ x-xxx 
(.65 to 2. Gm.). 

Constitutional Action. 
Physiological. Therapeutical. 

Within ten or twelve min- The powerful diaphoretic 
utes after jaborandi has been action of jaborandi, no less 
taken, the face flushes deeply, than its power in aiding the 
and profuse perspiration fol- elimination of urea, would 
lows, accompanied by a great 

1 British Medical Journal, Mav, 1877. 



JABORANDI. 



450 



rious chronic kidney-diseases 
[Bright's disease], as well as 
febrile conditions. But its 
action is too short, sharp, and 
sudden, and too much depres- 
sion and inconvenience are 
produced, to render us very 
hopeful of its ultimate success 
in practice. [Except in 
uraemia, where pilocarpia 
may be given hypodermi- 
cally.] 

It has been prescribed in 
diabetes insipidus, and fop 
the purpose of augmenting 
the secretion of milk. 



increase of salivary secretion, 
terminating in from two to 
four hours. The loss of fluid 
thus produced is very con- 
siderable, and the sweat has 
been proved to contain a 
large excess of urea. This 
action on the skin is consi- 
dered due to vaso-motor para- 
lysis and consequent dilata- 
tion of the cutaneous arteri- 
oles, and the sialagogue effects 
of the drug are attributed to 
stimulation of the periphery 
of the nerves supplied to the 
salivary glands. Jaborandi 
increases somewhat the action 
of the heart ; and contraction 
of the pupil, with impaired 
accommodative power, has 
been noted to attend its use. 

A good deal of nausea, de- 
pression, and general discom- 
fort result, and have been 
graphically described by Mr. 
Martindale in the " Lancet." 

Atropia and muscarine ap- 
pear to be in many respects 
an exact physiological anti- 
dote to jaborandi. 

[The alkaloid of Jaborandi, possessing both the diapho- 
retic and sialagogue properties of the drug, has received the 
name of — 

Pilocarpia — Piloearpin. 

Constitutional Effects. 



Physiological Effects. 
Dr. Popow (St. Petersb. 
Med. Woch., August 4), re- 
porting upon the results de- 
rived from the hypodermic 
injection of piloearpin in men 



Therapeutic Uses. 
From some comparative 
trials which he has " made 
with the internal administra- 
tion of piloearpin, Dr. Cursch- 
mann believes that the infre- 



4G0 



JABORANDI. 



in health and suffering from 
fever, and in experiments 
upon animals made in Prof. 
Suschtschinsky's laboratory, 
comes to the following con- 
clusions : — 

1. Pilocarpin produces the 
same effect as an infusion of 
the leaves of jaborandi. 

2. An injection of from 
gr. ^ to ^ (.01 to .02 Gm.) 
induces abundant sweating, 
without causing the unpleas- 
ant effects (giddiness, vomit- 
ing, cephalalgia) produced 
by jaborandi, and is, there- 
fore, better suited for thera- 
peutical employment. 

3. The temperature dimin- 
ishes without any prior ex- 
altation, from one hour and 
a half to four hours, and 
reaches its minimum soon 
after the cessation of the 
sweating. 

4. The increased excretion 
of saliva is observed alike in 
the healthy and the sick, 
after doses of from gr. J to \ 
(.01 to .015 Gm.). Sweat- 
ing only occurs in such doses 
in the healthy; fever pa- 
tients, e. g., typhus, requiring 
gr. i (.02 Gm.). 

5. The quickening of the 
heart's action produced by 
the pilocarpin continues a 
pretty long time after small 
doses, but when large ones 
are employed, this is soon 
replaced by retardation. 

6. On the direct introduc- 
tion of pilocarpin into the 



quency with which it causes 
vomiting, as compared with 
jaborandi, is principally due 
to its being used hypoder- 
mically, and thereby avoid- 
ing direct irritation of the 
stomach. Some persons, es- 
pecially those who have been 
weakened by prior disease, 
complain of a sense of debi- 
lity, but this usually soon 
passes off; but in others a 
complete state of collapse is 
produced, which may or may 
not be connected with prior 
vomiting. The possibility of 
this occurrence must always 
be borne in mind. It is de- 
pendent upon the amount of 
the dose and the susceptibi- 
lity of the individual. It is 
oftenest met with in women, 
and in those whose strength 
has been greatly reduced ; 
and when the patient's con- 
stitution is not known, the 
first dose of the medicine 
should not exceed gr. ^ (.02 
Gm.), while its effect should 
be watched for a quarter or 
half an hour. As far as the 
trials have gone, pilocarpin 
does not seem to act danger- 
ously on the subjects of heart- 
disease, and, indeed, can be 
employed when no other dia- 
phoretic procedure, for so 
long a period, would be ven- 
tured upon. Indeed, as a 
therapeutical agent for the 
production of diaphoresis, it 
is superior to any other me- 
thod in use, being more 



JABORANDI. 



4G1 



veins a retardation of the 
heart's action takes place 
suddenly, "without any prior 
acceleration. 

7. Doses not exceeding 
gr. -J (.03 Gm.) do not exert 
any particular effect on the 
alimentary canal ; but large 
doses, gr. | to gr. jss (.05 to 
.10 Gm.), induce purging, 
or even bloody stools, with 
intestinal movements, and the 
development of gases. 1 

The quantity of urine and 
the amount of urea are both 
increased during the twenty- 
four hours succeeding its ad- 
ministration. 2 

It is uncertain whether 
jaborandi exercises any direct 
effect upon the heart. 



easily employed, while its 
action is more certain and 
more complete, without being 
more, or even as dangerous, 
as most of them. Its supe- 
riority over the various 
sweating-baths in ascites, hy- 
drothorax, asthma, etc., is 
most marked. It is true 
that diaphoretic treatment is 
thought less of than formerly ; 
but in several cases the diffi- 
culty of its application, rather 
than its inelflcacy, is the 
cause of its not being resorted 
to. Speaking from his own 
experience, Dr. Curschmann 
has found the pilocarpin very 
useful in oedema, in dropsy 
of the cavities from heart or 
lung disease, and in chronic 
nephritis, etc., and that after 
diuretic, drastic, and other 
means have failed. He be- 
lieves that a large field for 
its employment may be found 
in pleurisy accompanied by 
serous exudation, both in 
promoting the absorption of 
this, and in preventing its re- 
accumulation after paracen- 
tesis. It is evidently indi- 
cated in chronic rheumatic 
affections, at least so far as 
these are amenable to dia- 
phoretic treatment, 3 and in 
some chronic skin affections, 



1 [Medical Xews and Library, Phila., Oct. 1S77. p. 154; from 
the Med. Times and Graz., Aug. 25, 1877.] 

2 [Drs. Tyson and Bruen, Am. Journ. Med. Sciences for July 1, 
1877.] 

8 [Phila. Med. and Snrg. Reporter for Oct. 6, L^77.] 

39* 



462 JAEORANDI. 

its use lias been attended 
with considerable success. 

Prof. Demme 1 gives, in dropsical affections of children, 
doses of gr. T V to ^ (.005 to .02 Gm.) of pilocarpine, which 
he regards as an efficacious diaphoretic and sialagogue in 
the treatment of certain diseases of children, and in appro- 
priate doses it is well borne by the youngest patients. Un- 
pleasant symptoms are of very rare occurrence, and can 
probably be altogether prevented by administering small 
doses of brandy before the injection. 

The cases for which pilocarpine is especially suitable are 
the parenchymatous inflammations of the kidney with dropsy, 
following scarlatina and diphtheria. In the majority of cases 
the flow of urine is decidedly increased, while the quantity 
of blood and albumen in the urine is diminished rather than 
augmented. 

Mode of Administration, and Dose. 

The infusion of the powdered leaves is a good method of 
exhibiting the drug. A drachm should be steeped in half a 
pint of hot water, and when sufficiently cool stirred up and 
one-half the quantity drunk, half an hour later the remainder 
should be taken, without straining the infusion. This is 
generally sufficient to cause profuse sweating within an hour. 
Ptyalism is less constant in its occurrence. Experience, 
however, is in favor of using some of the pharmaceutical pre- 
parations in preference to the crude drug, as being more 
reliable and agreeable. 

Pilocarpine is conveniently adminstered by hypodermic 
injection. Gerrard found that the nitrate and hydrochlorate 
of pilocarpin, in doses of one-half a grain, also produced the 
full effects of jaborandi in substance. 

The fluid extract of jaborandi is now largely used, the 
dose being a fluidrachm, representing a drachm of the leaves. 
An elixir is also made by some pharmacists containing the 
virtues of one drachm in six fluidrachms.] 

1 [Med. Exam., July, 1878.] 



CHERRY-LAUREL. 4G3 



[LIQUOR FERRI DIALYSATUS— SOLUTION OF 
DIALYZED IRON. 

This preparation is of recent introduction, and has been 
well received. When well made it is a clear, neutral, very 
deep wine-colored liquid, free from taste and apparent as- 
tringency, and bearing perfectly dilution with pure water. 1 
It is a pure and powerful chalybeate with all the advantages 
of iron in the usual form ; it is borne well by the stomach, 
and does not cause constipation nor distress the digestion. 
Chemically it would appear to be a ferric hydrate kept in 
solution by a small quantity of ferric chloride. It is made by 
precipitating ferric chloride with dilute water of ammonia, 
washing the ferric hydrate precipitated, dissolving it in a 
solution of ferric chloride, and placing the result in a dialyzer. 
Graham, the inventor of the process, believed that muriatic 
acid passes through the dialyzer, mainly, and that the iron is 
left in the form of the soluble, colloidal, ferric hydrate ; but 
in practice it has never been obtained entirely free from the 
chloride. Dialyzed iron would seem to furnish us with an 
efficient substitute for the hydrated sesquioxide in the treat- 
ment of 'poisoning by arsemous acid. It is precipitated by 
various salts, and should be administered alone in doses of 
from ten drops to a drachm, after meals. It claims to con- 
tain about the same proportion of iron as the muriated tinc- 
ture, and, as it is said not to injure the teeth, it proves an 
admirable substitute for it, in chlorosis, ancemia, and allied 
conditions. 2 ] 



LARICIS CORTEX— LARCH BARK [Pir. B.]. 
Larch bark is seldom if ever used in medicine. 



LAUROCERASI FOLIA— CHERRY-LAUREL 

LEAVES [Ph. B.] 

The distilled cherry-laurel water contains prussic acid, 
but, as it is very variable in strength, its use cannot be ad- 
vised. 

1 [Pliila. Med. Times, vol. vii. p. 492, article on Dialyzed Iron.] 

2 [See article on the " Hsematinic Properties of Dialyzed Iron." by 
Dr. Robt. Amory, in Boston Med. and Surg. Journal for April 3, 
1879, vol. c. p. 453.] 



4G4 NITROGLYCERIN. 

MORI SUCCUS— MULBERRY JUICE [Ph. B.] 

Is only used as a flavoring ingredient. 



MUSCARIN— MUSHROOM-POISON. 
[An active principle obtained from Agaricus Muscaria.'] 

Muscarin, like gelsemium, causes contraction of the pupil 
when administered internally, but dilatation when topically 
applied. Profuse perspiration and salivation, with flushing 
giddiness, intestinal griping, and depression of the heart's 
action follow its use. 

Murrel recommends it in the sweating of phthisis in dose 
of 5 minims of a one per cent, solution of liquid extract. 



[NITROGLYCERINUM-— NITROGLYCERIN. 

Trinitroglycerin or Glonoin. 

A pale, yellowish, oily liquid, crystallizing in needles at 
a low temperature, and has a density of 1.60 (59° F.). It 
is nearly insoluble in water, but dissolves freely in ether 
and alcohol, forming compounds that explode on percussion. 
It is the basis of various blasting compounds such as dyna- 
mite, glyoxylin, dualin, etc. 

Internal Effects. 
Nitroglycerin is a poison exerting a marked effect on the 
nervous system, even when given in minute doses, producing, 
according to Brunton and Tait, "accelerated respiration, 
paralysis, loss of reflex action, and, apparently to a great 
degree, of sensation, and death from stoppage of the respi- 
ration." In frogs, after death, the brain is anaemic and 
heart empty, but the lungs are engorged with blood. 

Medical Uses. 
It has been recommended for epilepsy, headache, and 
asthma ; it has no smell, but its vapors cause intense head- 
ache. 1 Of late it has been highly praised by Dr. Murrell 
for the relief of angina pectoris. Used in drop doses of a 
one per cent, solution and cautiously increased, marked 
effects are produced, it is said, and decided relief afforded. 2 ] 

1 [National Dispensatory, Philadelphia, 1879, p. 939.] 

2 [The Practitioner London, 1879, vol. xxii. p. 208.] 



NITROUS OXIDE GAS — PEPSIN. 



465 



NITROUS OXIDE GAS. 



[Made from nitrate 

Physiological Action. 

Laughing-gas has been 
generally introduced as an 
anaesthetic, a very brief inha- 
lation causing perfect insensi- 
bility, preceded occasionally 
by slight excitement, and at- 
tended by an amount of livid- 
ity which at first sight seems 
most alarming. It has been 
shown that this insensibility 
is simply a condition of modi- 
fied asphyxia, as during nar- 
cosis only two-thirds of the 
normal amount of carbonic 
acid is given off, and imme- 
diately after recovery only 
one-third. 



of ammonia by heat.] 

Therapeutical Action. 

Nitrous oxide »gas is very 
valuable for the performance 
of such small operations as 
tooth extraction ; but anaes- 
thesia cannot safely be kept 
up long enough to render it 
available during more pro- 
longed surgical manipula- 
tions. During its adminis- 
tration we must rigidly ex- 
clude all atmospheric air, and 
thus prevent those violent 
and varied evidences of ex- 
citement which have so often 
caused amusement during the 
old-fashioned inhalation of 
laughing-gas. 

A popular mode of procur- 
ing anaesthesia now is to take 
advantage of the rapid action 
of this gas in the first in- 
stance, and then continue the 
process by means of ether or 
ethidene dichloride. 



PEPSINA— PEPSIN. 

Pepsina Porci. 



Pepsin is the most import- 
ant digestive element of the 
gastric juice, and more espe- 
cially reduces the albuminoid 
and proteinaceous constitu- 
ents of food to a fit state for 
absorption. 

Pepsin probably acts, in 
part at least, by stimulating 



There can be little doubt 
that many dyspeptic condi- 
tions are due to a deficiency 
of gastric juice, and attempts 
may be made to supply this 
by prescribing pepsin, prefer- 
ably in combination with di- 
lute hydrochloric acid. 

In atonic dyspepsia, in va- 



406 



PETROLEUM. 



the secreting function of the 
stomach mucous membrane. 

The ordinary pepsin wines 
rapidly become inert, because 
the alcohol 'does not prevent 
the ferment from changing, 
glycerine alone having this 
power. [When given in 
combination with acids, on 
the contrary, the pepsin is 
much more active than in the 
form of powder. An artificial 
gastric juice thus made is of 
great service in weak diges- 
tion due to atony of the stom- 
ach.] 



rious ancemic and cachectic 
conditions, in the diarrhcea 
of children, -in some forms of 
spasmodic asthma, its use 
seems to be attended with 
good results ; but we may 
well share Dr. Wood's scep- 
ticism as to the possibility of 
materially aiding the diges- 
tion of food by the small 
doses usually prescribed. 

Pepsin has also been re- 
commended as an addition 
to nutritious enemata, so as 
to insure some preliminary 
digestion of the injected food, 
and the peptonised milk, 
gruel, and beef- tea, prepared 
as recommended by Roberts, 
of Manchester, with liquor 
pancreaticus are very useful 
when administered either by 
the mouth or the rectum. 



Dose, gr. ij-v (.12 to .30 Gra.). Or we may use Prof. 
Liebreich's Pepsin-Essenz. [It may be conveniently pre- 
scribed in the form of Saccharated Pepsin, Liquor Pepsi ni, 
Boudault's Acid Pepsin, or as Lacto-peptine.] 



[PETROLEUM— PETROLEUM. 

Rock or coal oil. 

To a limited extent in the South of Europe, but in great 
quantity in the United States, petroleum is found either ooz- 
ing from the ground or obtained by drilling wells. Crude oil, 
which is of a dark color of the consistence of molasses but 
decidedly fluorescent, yields by rectification a number of 
hydro-carbonaceous compounds, some of which have sufficient 
density to be used as ointments (cosmoline, vaseline, etc.). 
On account of their property of resisting oxidation, never 
becoming rancid in the hottest weather, unguentum petrolei, 
and petroleol, as they are called, are now being largely em- 
ployed as substitutes for lard as the basis of ointments. Coal 



PARSLEY. 4G7 

oil has been used externally as an ointment for painful rheu- 
matic joints and in the treatment of scabies with good results. 
The combination of ung. petrolei with carbolic acid (5 per 
cent.) on account of local anaesthetic effects of the latter, 
makes a very useful embrocation for chillblains. Cosmoline 
is an excellent unirritating dressing for burns and scalds, or 
excoriations and wounds and is much used in hospitals. In- 
ternally, crude oil has been given in the case of tapeworm, 
also in whooping cough and bronchitis, but is rarely used by 
the medical profession. In excessive doses it produces op- 
pression, giddiness, palpitation, faintness, and headache, but 
no tendency to stupor or even sleep. In one case frightful 
convulsions appeared, in another death occurred with symp- 
toms of gastro-enteritis on the twentieth day after it had been 
taken (Stille.) The urine after taking the oil has a peculiar 
odor, and it may have a special action upon the kidneys. 

Rhigolene, one of the light products, has been used to pro- 
duce cold with the hand-spray as a substitute for ether ; in 
chorea, when it is applied along the spine, and as a local 
anaesthetic for some surgical operations. Its garlicky odor 
and explosiveness are the principal objections to its use. 

Vaseline is a soothing and agreeable application in skin 
diseases, but wanting solidity, is best used in combination 
with white wax or other ointments. 

Kaposi strongly recommends an ointment in eczema, made 
by dissolving and thoroughly incorporating by heat equal 
parts of vaseline and lead plaster, adding a little oil of ber- 
gamot. 

[Cosmoline is also a petroleum product, which melts at the 
temperature of the body ; it is odorless, and as it does not be- 
come rancid like ordinary fats, it is a good basis for ointments. 
It also may be obtained as a cosmoline cerate, as fluid cos- 
moline, and in various combinations. It is an excellent 
dressing for burns.] 



[PETROSELIXOI— PARSLEY. 

The root of Petroselinum sativum (Lindley, Flor. Med.), 

U. S. Secondary. 

The neutral active principle, Apiol, has attained some 
reputation in the treatment of intermittent 's, and is also 
used in neuralgia and dysmenorrhea. Its nauseating taste 
requires it to be given in capsule (gr. 3 T 9 ^). Dose, one to 

four.] 



468 QUEBRACHO BARK. 

[QUEBRACHO— QUEBRACHO BARK. 1 

The bark of the tree Aspidosperma Quebracho (Schlechtendahl) . 

A member of the family of Apocyneae, the aspidosperma 
quebracho is a native of northern part of South America, and 
is obtained from the province Catamarea, 2 of the Argentine 
Republic, where it has long been popular as a febrifuge. 

In 1878, Sehickendanz sent some of this bark to Europe, 
as a succedaneum for cinchona bark, where Dr. Penzoldt, 3 
after testing its therapeutic effects, pronounced it a remedy 
of considerable power, and Fraude 4 isolated from it an alka- 
loid " aspodispermine," which is insoluble in glycerine, but 
dissolves in fats and oils ; and produces the same physiologi- 
cal effects as the bark itself. Dose, as an antiperiodic, gr. 
xviij. (Guttman). 

The following pharmaceutical preparations have been 
made : — 

Tinctura Quebracho (macerate in 5 parts alcohol, 
50 per cent, for 8 days and filter). 

Tinctura Quebracho Composita (bark 2, orange 
peel 1 part, alcohol 5 parts). 

Vinum Quebracho (bark 1, alcohol, 56 per cent., 2 
parts, white wine 1(3 parts). 

Elixir Quebracho. 

Extractum Quebracho Fluidum. Dose, tt^xx-Ix 
(1.30 to 4. Gm.). 

Physiological Effects. Therapeutical Effects. 

Digestive Tract. — Taste The tincture has been 
bitter, astringent, and per- recommended for diarrhoea 
sistent or nauseating. Sali- in phthisis ; and in chronic 
vation has appeared both in diarrhoea in children, 
dogs and man. Has some 
astringent effects upon the 
alimentary tract. When 
used for any length of time, 
disagreeable effects are often 
produced which forbid its 
continuance. 

1 Working Bulletin, Quebracho. Parke, Davis & Co., Detroit, 
■ 1880. 

2 Primke, Pharm. Zeitung, No. 9, 1880. 

3 G. Fraude, Berichte der Deutschen Chem. Gesellschaft, 1878. 

4 F. Penzoldt, Berlin Klinische-Wochenschlft, No. 19, 1879. 



RESORCIN. 



4G9 



Nervous System Motor 

paralysis of the limbs of 
central origin (Penzoldt). 
Paralysis of respiration, dim- 
inished frequency of heart's 
action (not due to inhibition). 
Death caused by general 
paralysis, dyspnoea, and con- 
vulsions (from apnoea?). 



Respiration. — Breathing 
deepened and retarded by 
moderate doses. 

Special Action. — Princi- 
pally upon motor apparatus 
of respiration. No percep- 
tible influence upon tempera- 
ture, nor upon malarial mani- 
festations. 



In moderate doses may 
relieve restlessness of fevers, 
but has special value where 
the respirations are increased 
greatly above the normal. 
In attacks of rapid breathing 
during consumption, and in 
cases of palpitation accom- 
panying cardiac hypertrophy 
quebracho has given marked 
relief. 

It is used with great bene- 
fit in emphysema, bronchial 
catarrh, periodic asthma, etc. 
In asthma dependent upon 
valvular insufficiency it is 
less valuable than in spas- 
modic asthma where it ex- 
erts a special action.] 



[RESORCIN— RESORCIN. 

Dose, gr. x-3j (.65 to 4. Gm.). 

Resorcin (C 7 H s 2 ) is formed by fusing certain gums (gal- 
banum, assafoetida, ammoniac, etc.), with potassium hydrate, 
the resulting mass dissolved in water super-saturated with 
sulphuric acid, subsequently filtering and agitating the fil- 
tered solution with ether which dissolves out the resorcin, 
and from which it is subsequently obtained by evaporating, 
and distilling; the resorcin sublimes and condenses in radiated 
crystals. (TVurtz.) The crystals are colorless and very solu- 
ble in water, alcohol, and ether. 

Resorcin is very destructive to infusoria and the low forms 
of organisms of fermentation and putrefaction, it is more 
active even than carbolic acid. It may be applied locally to 
parasitic skin diseases, or suppurating wounds, without pro- 
ducing irritation. 

Taken internally it accelerates the pulse, stimulates the 

secretions, increasing the flow of the saliva and the activity 

of the sudoriparous glands; and secondarily depresses the 

temperature and the circulation. As an antipyretic the dose is 

40 



470 BUCKTHORN — SALICIN. 

from gr. xx to 3j (1-33 to 4. Gm.), and in this dose it has 
been used in hyperpyrexia to meet the same indications as 
maximum doses of quinia, for which it may be substituted. 
It may also be administered hypodermically.] 



RHAMNI SUCCUS— BUCKTHORN [Ph. B.]. 

Buckthorn lias some purgative properties, but is almost 
never used in modern practice. 

ROTTLERA—KAMALA, U. S. Secondary. 

\The glandular powder and hairs obtained from (he capsules of Rottlera 
tincloria (Roxburgh), U. S. 

Dose, 5 j-iij (4. to 12. Gm.).] 

Effects. 

Physiological. Therapeutical. 

Kamala is a vermicide, Kamala is an efficient an- 

killing the tape-worm rapidly ; thelmintic, differing from 

it also possesses purgative other remedies of the class 

properties. in its cathartic action. 



SALICIN. 

Salicin acts as a bitter tonic, and has some antiseptic and 
antiperiodic qualities, which have caused it to be used, with 
only partial success, in the treatment of malarial affections. 
Recently, however, it has been most extensively employed, 
on the recommendation of Dr. Maclagan, as a remedy for 
acute rheumatism, in which disease from 10 to 30 grains, 
every two, three, or four hours, in powder mixed with water, 
generally succeeds, within forty-eight hours, in relieving 
pain and reducing temperature. Dr. Maclagan holds it to 
be safer than salicylic acid which is apt to depress the heart, 
weakened and softened as it often is in acute rheumatism 
and myocarditis. It is also a useful remedy in neuralgia. 

[Although salicin is far less efficient in malarious affec- 
tions than the alkaloids of cinchona bark, it may be used 
with more effect than quinia to reduce the temperature in 
the hectic fever of phthisis ; a preliminary dose of twenty 
grains given before the fever comes on, renders the patient 
more comfortable, and often prevents the exacerbation.] 



SUMBUL — TRTMETHYLAMINE. 471 

SUMBUL 

Has antispasmodic properties, but is very rarely prescribed- 



THYMOL. 

This is an excellent antiseptic, less powerful than car- 
bolic acid, but ten times less poisonous, and much less irri- 
tating. 

Prof. Yolkman has used it instead of carbolic acid in car- 
rying out Prof. Lister's antiseptic plan, and recommends 
the following solution : — 

$. Thymol. 
Alcoholis 
Grlycerinse 
Aquae 

To be used as a spray. 

It has also been found a good application in eczema and 
psoriasis, and ringworm. 

[The glycerite of thymol diluted with water makes an 
excellent mouth wash : — 

I£. Thymolis gr. xviij or 1 2 dm. 
Grlycerinfe, 

Alcoholis aa^vijss " 30 " 

Aquae destiUat. gxvij " 540' " M. 

(Pharmac. Central., 1881, p. 1G7.)] 



gr. XV 


or 1 Gm. 




Sijss ; 


« 10 << 




5?v ; 


" 20 " 




Oij; 


" 1000 " 


M. 



TRIMETHYLAMINE AND ITS HYDRO- 
CHLORATE. 

Trimethylaminis hydroehloras. Dose gr. iij-x 
(.20 to .65 Gm.). 

Propylamine is an impure trimethylamine. 

Lowering of temperature and pulse is said to follow the 
use of this drug, and it has been much recommended as a 
remedy for acute rheumatism. [Trimethylamine is irritat- 
ing to the stomach, and should be given well diluted; pep- 
permint water is the usual vehicle. On account of its de- 
pressing effect upon heart and lungs, it may lead to fatal 
narcosis from retention of carbonic acid in the blood. The 
proper treatment of poisoning would be by opium and bella- 
donna (morphia and atropia), and stimulants. Ammonia 
should not be used.] 



472 



LEECHES. 



LEECHES. 

\_Hlrudo. Sartguisuga Officinalis."] 

Leeches are undoubtedly the most convenient means for 
the local abstraction of blood, and are used to relieve pain, 
which they do very effectually in certain local inflammations, 
as pleurisy, pericarditis, orchitis, iritis, hepatitis, perito- 
nitis ; and there is reason to believe that, when applied 
sufficiently early, they may even moderate the inflammatory 
process. Their action, no doubt, may frequently be ex- 
plained by direct vascular communication between superficial 
vessels and those of deeper parts. 

Each leech may contain about 1^ dr. of blood, and subse- 
quent fomentation may draw so much more from the skin as 
to raise the total amount up to half an ounce. Should the 
subsequent bleeding prove difficult of arrest, as sometimes 
happens, we may succeed in staunching the flow by means 
of pressure, cold, various astringents, the application of solid 
nitrate of silver, or the twisted suture. [The American 
only takes about one-third as much blood as the imported 
leech, and, on this account, is preferred by some in the treat- 
ment of diseases of children.] 

Special cautions in the use of leeches are — never to apply 
them, if possible, to any part over which firm pressure can- 
not subsequently be made, as the larynx; not to apply them 
in the evening, when, for some unexplained reason, the 
bleeding is more apt to be troublesome ; and, of course, 
never to allow their use in any victim of the hemorrhagic 
diathesis. 

If leeches will not bite, we must smear the skin with 
cream or freshly-drawn blood, or immerse the animal itself 
in porter, which seems to have a stimulating effect ; and 
should one be accidentally swallowed we can kill it, and 
cause its expulsion from the stomach, by common salt. 



APPENDIX. 

(ADDED BY THE AMERICAN EDITOR.) 



POISONS. 



A poison is a substance, of animal, vegetable, or mineral 
nature, which, when administered in small quantity, is capa- 
ble of producing deleterious effects upon the human system. 
It may be introduced into the economy in a gaseous, liquid, 
or solid form, through any of the channels of absorption, 
though more commonly by the gastro-intestinal tract. 1 

General Antidote for Poisoning when the Nature 
of Poison is Unknown. 

I£. Magnesiae, 

Pulv. carbo. ligni, 
Ferri oxidirubri, aa. M. 

To be given freely in a sufficient quantity of water. 

Or, as suggested by Jeannel — 

Calcined magnesia, ^ij ; 

Washed animal charcoal, |j ; 

Water, §xx ; 

to be kept well covered ; when exhibited to be mixed with 
Solution of ferrous sulphate (sp. gr. 1.45) §ijss, and well agitated. 

Given in doses of §jss-iij in poisoning by arsenic, zinc, the alka- 
loids, etc. 2 

This preparation is harmless, but is effective, for its ingre- 
dients are antidotes to the most common and active poisons. 
With it may be given demulcent drinks, such as milk or 
flour and water, to dilute the poison and protect the stomach. 

1 See title Antidotes for general considerations, page 51. 

2 The Practitioner's Reference Book, R. J. Dunglison, Phila., 
1S79, p. 228. 

40* 



474 



TREATMENT OF POISONING. 



Prompt Treatment Table of Poisons. 



Arranged alphabetically for ready reference. 

Acetic Acid. — The alkaline carbonates, chalk, or magnesia. 
Vomiting should be encouraged and demulcent drinks freely 
given. 

Aconite, — Active emetics, or stomach-pump. Stimulation exter- 
nally and internally. Digitalis is a physiological antidote ; also 
finely-powdered animal charcoal, or tannin, and astringent in- 
fusions. 

Alcohol. — Stomach-pump ; cold affusion ; inhalation of vapor or 
hypodermic injection of ammonia ; use of electricity, etc. 

Alum, and Sulphate of Alumina and Potassa. — Warm dilute drinks 
to produce emesis ; hydrate of magnesia, or weak solution of car- 
bonate of ammonia; stomach-pump. 

Ammonia. — Vegetable acids, as a little vinegar or lemon-juice ; olive 
oil ; milk given copiously : stomach-pump should not be used. 

Amylene. — Same treatment as for chloroform poisoning. 

Antimony and its Salts. — Tannin, as in tincture or infusion of 
cinchona, infusion of green tea, or of galls. Free vomiting with 
warm mucilaginous drinks, or stomach-pump. Opium, and in- 
ternal and external stimulation may be employed subsequently. 

Absenious Acid. — Hydrated sesquioxide of iron, to be given in a 
moist state, in tab'lespoonful doses, followed by castor-oil. (The 
hydrate may be extemporaneously prepared by adding aqua 
ammonias to dilute tinctura ferri chloridi.) Solution of dialyzed 
iron, and freshly-precipitated hydrate of magnesia have also been 
employed. These are not reliable if the arsenic has been taken in 
form of powder. In the absence of vomiting, prompt emesis by 
sulphate of zinc or warm mustard and water. Warm demulcent 
drinks. 

Barium, Salts of. — Sodium or magnesium sulphate ; emetics and 
stomach-pump. 

Belladonna. — No reliable chemical antidote ; tannin and animal 
charcoal have been employed. Physiological antidote, morphia, 
w r hich may be administered subcutaneously. Usual treatment 
for narcotic poisons. 

Bismuth Subnitrate. — Albumen, milk, sugar, mucilaginous drinks. 

Brucia. — Same treatment as for poisoning by mix vomica. 

Calabar Bean. — Physiological antidote, atropia, cautiously admin- 
istered hypodermic-ally. 

Camphor. — Emetics, stimulants, wine, and opium. 

Canthaeides. — Free emesis to be encouraged with warm demulcent 
drinks ; castor oil ; demulcent injections. 

Carbolic Acid. — Saturated solution of saccharate of lime has been 
recommended as an antidote. Early use of the stomach-pump. 
Olive oil ; flour and water, etc. 

Carbonic Acid Gas. — Artificial respiration, friction, stimulants, 
fresh air, and electricity. 



TREATMENT OF POISONING. 475 

Chloral. — Stomach-pump ; stomach washed out with tea or coffee. 
Diffusible stimulants. General treatment same as for narcotic 
poisoning, or poisoning by chloroform vapor. Heat externally. 

Chloroform. — In poisoning by liquid chloroform, use the stomach- 
pump and emetics. If collapse occur during anaesthesia, re- 
verse the patient as recommended by Gross. Ammonia by inha- 
lation, ice in rectum, hypodermic injections of brandy and am- 
monia, electricity, etc. 

Chromium, Compounds of. — Magnesium carbonate or chalk, in 
milk, albumen, or water, followed by emetics. 

Citric Acid. — Alkaline carbonates, chalk, or magnesia. 

Cocculus Indicus. — Mucilaginous drinks, stimulants, and emetics. 

Colchicum. — Prompt emesis, castor oil, demulcents, opium, and 
stimulants. 

Conium. — Mustard and warm water. Active stimulation, exter- 
nally and internally. 

Copper, Preparations of. — Antidote, white of eggs freely admin- 
istered, or milk. Vomiting should be aided by warm muci- 
laginous drinks ; stomach-pump if necessary. 

Corrosive Sublimate. — Albumen, mixed with water and given 
copiously, forms insoluble compounds ; white of one egg neutral- 
izes four grains of corrosive sublimate. Gluten, or wheat flour 
paste, or milk, also employed. Free vomiting, aided by warm, 
diluent drinks ; stomach-pump to be used with caution — may 
produce perforation. 

Creasote. — Emetics or stomach-pump ; demulcent and mucilagi- 
nous drinks. 

Croton Oil. — Same general treatment as for other irritant poisons, 
to counteract excessive vomiting and purging. Opium, stimu- 
lants, demulcents. 

Curare. — Same general treatment as that mentioned for poisoning 
by narcotics ; artificial respiration, hot coffee, etc. 

Cyanide of Potassium. — See Potassium cyanide. 

Digitalis. — Vegetable infusions containing tannic acid render the 
active principle insoluble. Give emetics and hot applications to 
surface. 

Ether, Vapor of. — Cold affusion ; exposure to current of air ; arti- 
ficial respiration, electricity. 

Gold, Preparations of. — Sulphate of iron ; mucilaginous drinks. 

Hydrochloric Acid. — See Muriatic Acid. 

Hydrocyanic Acid. — Mixture of protosulphate and sesquisulphate 
of iron (ferrous and ferric sulphate), followed by solution of 
potassium carbonate. Being rapidly fatal, treatment must be 
instantaneous. Cold affusion ; cautious inhalation of ammonia 
and chlorine vapors ; stimulation externally and internally. 

Hyosctamus. — Same general treatment as for poisoning by bella- 
donna and vegetable narcotics. 

Iodine. — Starch, or flour, in water. 

Iron. Chloride and Sulphate. — Magnesia, copious diluent drinks. 

Lead Salts. — Zinc sulphate, producing free emesis. and forming 
insoluble leid sulphate. Milk and white of egg, given copiously, 
form insoluble compounds. Solutions of magnesium or sodium 



476 TREATMENT OF POISONING. 

sulphate, freely administered, act as antidotes and cathartics ; 
castor oil may also be administered. 

Lobelia. — Emetics, purgatives, anodynes, stimulants. 

Methylene, Bichloride of. — Same treatment as for poisoning by 
chloroform vapor. 

Morphia. — See opium. 

Muriatic or Hydrochloric Acid. — Solution of alkaline carbonates 
in water or milk ; magnesia or chalk suspended in milk ; soap- 
suds ; scrapings from whitewashed walls (in the absence of other 
articles) ; free use of barley water, oily emulsions, gruel, and 
milk in large quantities. 

Nitrate op Potassium. — See Potassium. 

Nitric Acid and Nitromuriatic Acid. — Same treatment as already 
detailed for poisoning by muriatic acid. Dilute solution of 
sodium carbonate, or fluid magnesia, with water, and milk or 
demulcents may be given. 

Nitrous Oxide. — Same general treatment as for poisoning by chlo- 
roform vapor. 

Nux Vomica. — See Strychnia. 

Oil of Bitter Almonds. — Same treatment as for hydrocyanic-acid 
poisoning. 

Opium, and its Preparations. — Antidotes, tannic acid and iodated 
iodide of potassium. Physiological antidote, solution of atropia 
or tincture of belladonna. Treatment, direct emetics, as large 
doses of zinc sulphate, repeated if necessary, or mustard and 
warm water, or stomach-pump. For the narcotic effect of the 
drug, affusion with cold water, walking the patient, arousing 
him by shaking and shouting ; flagellations ; enemata of strong 
coffee. If unsuccessful, electricity and artificial respiration. 

Oxalic Acid. — Avoid the use of alkalies or their carbonates, as 
they form poisonous salts with the oxalic acid. Give chalk or 
calcined magnesia, or its carbonate, suspended in water or milk, 
which forms insoluble and inert earthy oxalates ; or saccharated 
solution of lime. After-treatment, mucilaginous drinks, lime- 
water, and oil ; warmth and stimulants. 

Phosphorus. — Free vomiting by cupric sulphate ; albuminous and 
mucilaginous drinks, in which hydrate of magnesia is suspended. 
Oil, being a solvent of phosphorus, should be avoided. Old oil 
of turpentine (containing oxygen), oxygenated water, oxygen 
inhalations, animal charcoal, have been employed as antidotes. 

Physostigma. — See Calabar Bean. 

Potass a. — Mild vegetable acids, as dilute vinegar or lemon-juice ; 
demulcent drinks ; olive oil, in large quantities, produces a soap. 
Milk may be copiously administered. Stomach-pump should not 
be used. 

Potassium Bitartrate (cream of tartar). — Same treatment as for 
the nitrate. Dilute solution of potassium bicarbonate reduces 
bitartrate to harmless neutral tartrate. 

Potassium Cyanide. — Weak solution of ferrous sulphate converts it 
into Prussian blue ; subsequent treatment similar to that for 
hydrocyanic acid. 



TREATMENT OF POISONING. 477 

Potassium Nitrate. — No direct antidote ; stomach-pump ; free 
vomiting, and copious mucilaginous drinks ; stimulants, opium, 
and coffee, if great depression exist. 

Prussic Acid. — See Hydrocyanic Acid. 

Silver, The Salts op. — Albumen, milk. If nitrate, give the chlo- 
ride of sodium, followed by emetics. 

Soda, and its Preparations. — Same treatment as for potassa 
poisoning. 

Stramonium. — Same treatment as for poisoning by belladonna. 
Morphia should be administered hypodermically. 

Strychnia. — Bromide of potassium, in very large doses. Hydrate 
of chloral, nitrite of amyl, and atropia have also been recom- 
mended. Prompt emesis by stomach-pump, or mustard and 
warm water, or mixture of ipecacuanha and zinc sulphate. Inha- 
lation of chloroform, continuously enjoyed, may relieve tetanic 
rigidity. 

Sulphuric Acid. — Same treatment as for poisoning by muriatic 
acid. Solution of sodium carbonate in milk and water. Stomach- 
pump must not be used. 

Sulphate of Indigo. — Calcined magnesia and milk, or fluid mag- 
nesia. 

Tartaric Acid. — Same treatment as for poisoning by citric acid or 
oxalic acid. 

Tartar Emetic — See Antimony. 

Tobacco. — Stomach-pump or emetics ; whiskey, strychnia, stimu- 
lating injections per anion, containing turpentine or ammonia. 

Veratrum. — Rapid emesis, stimulants, with laudanum or some 
other opiate. Tannin has been proposed as an antidote. 

Zinc Chloride. — Albumen given liberally. Free emesis, copious 
warm mucilaginous drinks, or stomach-pump. 

Zinc Sulphate. — Tepid water with milk and albumen ; infusions 
containing tannic acid. Stomach-rmurp. Laudanum and starch 
enemata. 

There are a number of so-called vegetable irritants, such as 
aloes, scammony, and jalap, which may give rise to toxical 
symptoms. Their effects should be treated on general prin- 
ciples, such as the employment of emetics, diluents, castor 
oil, opium, and fomentations. The same remarks apply also 
to the various articles of diet, such as meat, fish, lobsters, or 
fruits, which occasionally produce similar results. Irritant 
gases, as chlorine, nitrous acid, or sulphurous acid vapor, 
etc., may act as poisons, and their effects should be treated 
by removal of the patient from the causes, cold affusion, and 
by antidotes as directed. The numerous poisonous fungi, 
which may be taken into the stomach, may also produce 
symptoms, and require treatment on general principles. 



478 



TABLE OF POISONS AND ANTIDOTES 



Bites of venomous reptiles require special treatment ; the 
wound may be sucked with impunity, provided there be no 
abrasion upon the lips or tongue. The limb above the point 
having a ligature placed around it, or compressed, the part 
involved may be excised or cauterized with the hot iron or 
nitric acid. The intravenous injection of ammonia has also 
been advised. Stimulants, as ammonia or brandy, should 
also be freely given. The local treatment here detailed 
would also be applicable to bites of rabid animals. 

The following table (after Taylor " On Poisons,") gives a 
comprehensive review of the most approved antidotes for the 
several principal poisons noticed in the foregoing pages. 



NON-METALLIC POISONS. 



Mineral 
Acids 

Vegetable 

Acids 
and their 
Alkaline 

Salts. 

Alkalies. 



Poisons. 

J Sulphuric "] 

Nitric { 

i Muriatic 

[ Nitro-muriatic J 

f Oxalic ) 

Tartaric $ 

Potassium Binoxa- "] 

late 

| Potassium Bitar- { 

I trate J 

C Potass a, soda, am- j 

1 monia, and their > 

f carbonates ) 



Antidotes. 
Magnesia mixed with water or 

milk ; calcium carbonate ; 

compound chalk powder ; 

soda ; potassa ; the fixed oils. 
Calcium carbonate (chalk or 

whiting). 

Calcium carbonate. Calcium 

sulphate, and water. 
Sodium carbonate in solution. 



Vinegar, lemon -juice, 
acid, or oil. 



citric 



METALLIC POISONS. 



Arsenic and soluble arse- 
nites. 

Corrosive sublimate, and salts 
of mercurv. 



Phosphorus. 

Baryta and its soluble salts. 

Barium carbonate. 

Alum. 

Soluble salts of lead. 

Lead carbonate. 



f Hydrated peroxide of iron ; hy- 

j drated magnesia ; solution of 

] dialyzed iron. 

L Mixture of oil and lime-water. 

f Albumen, gluten, or flour, diffused 

( in water or milk. 

C Cupric sulphate ; old oil of tur- 

< pentine ; water containing mag- 

( nesia. 

Sodium, potassium, magnesium, 
or calcium sulphate. 

Mixture of magnesium sulphate 
and vinegar. 

Sodium or ammonium carbonate. 

The alkaline, or soluble earthy 
sulphates. 

Magnesium sulphate and vinegar. 



TABLE OF POISONS AND ANTIDOTES. 

Poisons. 

Soluble salts of copper. 



479 



Tartar emetic. 

Antimony chloride. 
Salts of tin. 

Zinc sulphate, or acetate. 

Ferrous sulphate. 
Silver nitrate. 



Antidotes. 
Albumen, gluten, flour diffused in 
water ; milk. 

{Decoctions and tinctures contain- 
ing tannic acid. 
Magnesia. 

Sodium carbonate ; magnesia. 
5 Milk ; sodium carbonate ; mag- 
( nesia. 

{ Milk ; sodium carbonate ; mag- 
( nesia. 
Sodium or ammonium carbonate. 
Sodium chloride, and emetics. 



NARCOTIC POISONS. 



Opium ; hyoscyamus. 



Prussic acid. 



f Emetics ; stomach-pump, cold af- 
j fusion. Strong decoction of cof- 
j fee ; electro-magetism ; tannic 
{ acid. 
f Ammonia ; chlorine ; cold affusion ; 

iron and potassium carbonate 
! (see p. 105) ; or cupric sulphate 
j (1 Grm. followed by 0.5 Grm., every 

five minutes until vomiting is 
I produced). 



MODES OF DISTINGUISHING- SOME OF THE VEGETABLE 
ALKALOIDS WHEN IN POWDER. 

Treat the powder with nitric acid ; this is colored red by 
Brucia, Delphinia, Morphia, and by the Strychnia of com- 
merce, but not the pure. If the reddened acid become 
violet on the addition of protochloride of tin, it is Brucia; 
if it become black and carbonaceous, it is Delphinia. If the 
powder be fusible without decomposition, and decompose 
iodic acid, it is Morphia; if it be not fusible without decom- 
position, and do not decompose iodic acid, it is StrycJraia. 
If the powder strike a green with nitric acid, it is Solania ; if 
insoluble in ether, and do not redden nitric acid, it is Enietia ; 
if insoluble in ether, and do not redden nitric acid, but should 
melt and volatilize with heat, it is Atropia; if thus affected 
by ether or nitric acid, but do not volatilize, it is Veratria. 
(Griffith.) 



480 PTOMAINES. 



PTOMAINES. 



It has recently been announced that during decomposition 
of the human body substances are formed called Ptomaines, 
which give reactions very much like some of the above 
alkaloids. Their existence should put the examiner on his 
guard. Gautier declares that they may occur in the living 
body, and he has extracted a poison resembling that of ser- 
pents from human saliva, and from the urine he has also 
obtained the so-called cadaveric alkaloids. Ptomaines are 
distinguished from the alkaloids veratria, morphia, and 
codeia with difficulty, but a plan has been devised by 
Brouardel and Boutmy (Comptes Rendus, 92, p. 1056 ; 
Annales d'Hygiene, v. p. 497), by which this is accom- 
plished by potassium ferricyanide and silver bromide as re- 
agents : " If a base be present, indicated by the formation 
of a precipitate with potassium iodo-mercurate, and this 
instantly change potassium ferricyanide into ferrocyanide, 
giving a precipitate of Prussian blue on the addition of 
ferric-chloride, a ptomaine is present ; whereas precipitation 
by the iodo-mercurate, coupled with the non-reduction of 
the ferricyanide to the ferrocyanide, shows that a vegetable 
alkaloid is being dealt with. Morphia and veratria, of the 
vegetable alkaloids, are exceptions to the above reaction." 
This may be supplemented by the silver test. If a piece of 
photographic paper imbued with the bromide of silver, be 
written upon with a quill pen dipped in a solution of the 
base, and the paper be placed in a dark room, and then 
washed successively with sodium hypo-sulphite and water, 
the characters traced upon the paper will be made manifest 
by reduction which has occurred, if a ptomaine be present." 
(Lond. Med. Record, vol. ix. p. 451.) 



WEIGHTS AND MEASURES. 



APOTHECARIES' WEIGHTS AND MEASURES. 



One Pound, 
One Ounce, 
One Drachm, 
One Scruple, 
One Grain, 



ft 
I 
5 



12 Ounces 
8 Drachms 
3 Scruples 



5,760 Grains. 

4S0 Grains. 

60 Grains. 

20 Grains. 

1 Grain. 



One Gallon, C 

One Pint, 

One Fluidounce, f ^ 
One Fluidrachm, f 5 
One Minim, TT[ 



8 Pints = 61,440 Minims 

16 Fluidounces = 7,680 Minims 

8 Fluidrachms = 480 Minims. 

= 60 Minims. 

= 1 Minim. 



Kate. — In prescribing, the troyounce, drachm, and grain, or the fluidounce, 
drachm, and minim, only should be used. 

RELATION OF WEIGHTS AND MEASURES OF THE U. S. 
PHARMACOPOEIA TO EACH OTHER. 
In distilled water at the temperature of 60°. 



One Pound 
One Ounce 
One Drachm 
One Scruple 
One Grain 



0.7900031 Pint = 

1.0533376 Fluidounces = 
1.0533376 Fluidrachms = 



6,067.2238 Minims. 

505.6019 Minims. 

63.2002 Minims. 

21.0667 Minims. 

1.0533 Minims. 



One Gallon =10.1265427 Pounds 
One Pint = 1.2658178 Pounds 
One Fluidounce = 0.9493633 Ounce 
One Fluidrachm = 0.9493633 Drachm 
One Minim 



=58,328.8862 Grains. 
= 7 291.1107 Grains. 
= 455.6944 Grains. 
= 56.9618 Grains. 
= 0.9493 Grain. 



RELATION OF MEASURES OF THE U. S. PHARMACOPOEIA 
TO CUBIC MEASURE. 



One Gallon 
One Pint 
One Fluidounce 
One Fluidrachm 
One Minim 



11 



231. Cuhic Inches. 

28.S75 Cubic Indies. 

1.80468 Cubic Inches. 

0.22558 Cubic Inch. 

0.00375 Cubic Inch. 



482 



WEIGHTS AND MEASURES. 



WEIGHTS AND MEASURES OF THE METRIC SYSTEM. 

MEASURES OF LENGTH. 

One Myriametre = 10.000 Metres. 
One Kilometre = 1,000 Metres. 

One Hectometre = 100 Metres. 
One Decametre = 10 Metres. 

One METRE = the ten-millionth part of a quarter of the 

meridian of the earth. 
One Decimetre = the tenth part of one Metre, or 0.1 Metre. 
One Centimetre = the hundredth part of one Metre, or 0.01 

Metre. 
One Millimetre = the thousandth part of one Metre, or 0.001 

Metre. 

(A metre is equal to 39.37 inches ; a centimetre to T 4 ff of an inch ; 
and a millimetre to ^ of an inch.) 

WEIGHTS. 

One Myriagramme = 10,000 Grammes. 
One Kilogramme = 1,000 Grammes. 
One Hectogramme = 100 Grammes. 
One Decagramme = 10 Grammes. 

One GRAMME = the weight of a cuhic centimetre of water at 

4° C. 
One Decigramme = the tenth part of one Gramme, or 0.1 Gramme. 
One Centigramme = the hundredth part of one Gramme, or 0.01 

Gramme. 
One Milligramme = the thousandth part of one Gramme, or 0.001 

Gramme. 



MEASURES OF CAPACITY. 

One Myrialitre = 10 cuhic Metres, or the measure of 10 Mil- 

liers of Water. 
One Kilolitre = 1 cubic Metre, or the measure of 1 Millier 

of Water. 
One Hectolitre = 100 cuhic Decimetres, or the measure of 1 

Quintal of Water. 
One Decalitre = 10 cuhic Decimetres, or the measure of 1 

Myriagramme of Water. 
One LITRE = 1 cubic Decimetre, or the measure of 1 

Kilogramme of Water. 
One Decilitre = 100 cubic Centimetres, or the measure of 1 

Hectogramme of Water. 
One Centilitre = 10 cubic Centimetres, or the measure of 1 

Decigramme of Water. 
One Millilitre = 1 cubic Centimetre, or the measure of 1 

Gramme of Water. 



WETLJnTS AND MEASURES. 



483 



RELATION OF METRICAL WEIGHTS TO WEIGHTS OF THE 
U. S. PHARMACOPEIA. 



Metrica' 
weight 


i. 


Exact. 

equivalents 

in grains. 


Approximate 
equivalents 

in grains. 


Metrical 
weights. 


Exact. 

equivalents 

in grains. 


Approximate 
equivalents 

Troy weight. 


Milligramme 


;. 




Grammes. 




1 


= 


.0154 


6o 


1 


= 


15.434 


gr. xv. 


2 


s=s 


.0308 


1 
3 2 


2 


= 


30.868 


5ss. 


3 


= 


.0463 


1 
2 2 


3 


= 


46.302 


Bij- 


4 


= 


.0617 


1 
1 6 


4 


= 


61.736 


5i. 


5 


= 


.0771 


1 


5 


= 


77.170 


9iv. 


6 


= 


.0926 


TT 


6 


= 


92.604 


3iss. 


i 


= 


.1080 


1 
■9 


7 


= 


108.038 


9vss. 


8 


= 


.1234 


1 


8 


= 


123.472 


5ij- 


9 


= 


.1389 


1 
1 


9 


= 


138.906 


Bvij. 


Centigramme 






Decagrammes. 




1 


= 


.1543 


1 

6" 


1 


~ 


154.340 


Siiss. 


2 


= 


.3086 


1 


2 


= 


308.680 


5v. 


3 


== 


.4630 


6 
13" 


3 


= 


463.020 


5viiss. 


4 


= 


.6173 


7 
1 1 


4 


= 


617.360 


3x. 


5 


= 


.7717 


3 


5 


= 


771.701 


5^iij- 


6 


= 


.9260 


9 
1 9 


6 


= 


926.041 


5xv 


7 


= 


1.0803 


1 


7 


= 


1,080.381 


5xviij. 


8 


= 


1.2347 


H 


8 


= 


1,234.721 


3xx. 


9 


= 


1.3890 


H 


9 


= 


1,389.062 


3xxiij. 


Decigrammes 






Hectogrammes. 




1 


= 


1.543 


n 


1 


= 


1,543.402 


lii.i 3^ 


2 


= 


3.086 


3 


2 


= 


3,086.804 


§vj 3iij. 


3 


= 


4.630 


4* 


3 


= 


4,630.206 


§ix gv. 


4 


= 


6.173 


6 


4 


= 


6,173.609 


l°j .^vij. 


5 


= 


7.717 


7 2 


5 


= 


7,717.011 


ftj §iv. 


6 


= 


9.260 


9 


6 


= 


9,260.413 


ftj ?vij. 


7 


= 


10.803 


11 


7 


= 


10,803.816 


Ibj §x 5iv. 


8 


= 


12.347 


12 J 


8 


= 


12,347.218 


Ibij l\ 3 v. 


9 


= 


13.890 


14 


9 


= 


13,890.620 


B>U £v. 










Kilo 


gramme. 












1 


= 


15,434.023 


ftij §viij. 










Myriagramme. 












1 


=154,. 340. 23 -j 


Ifoxxvi. 

=ix 3iv. 



484 



WEIGHTS AND MEASURES. 



RELATIONS OF WEIGHTS OF THE U. S. PHARMACOPOEIA 
TO METRICAL WEIGHTS. 



Fractions of a 


?rain ia 


Grains iu 


equivalent 


Drachms, 
pounds in 


ounces, and 
equivalent 


g 


rammes. 


metrical weights. 


metrical 


weights. 


Grain. 


G 


famines. 


Grains. 


Grammes. 


Drachms. 


Grammes. 


l 
64" 


= 


0010 


1 = 




0648 


1 = 


3 


887 


60 


= 


0011 


2 = 




1295 


2 = 


7 


775 


To 


= 


0013 


3 = 




1943 


3 = 


11 


(iQ 


l 

4 8 


= 


0014 


4 = 




2591 


4 = 


15 


55 


40 


= 


0016 


5 = 




3239 


5 = 


19 


43 


3"T; 


ss= 


0018 


6 = 




38^7 


6 = 


23 


32 


1 
J~0 


= 


0022 


7 = 




4535 


7 = 


27 


21 


1 
2~5 


= 


0026 


8 = 




5183 






2T 


= 


0027 


9 = 




5831 


Ounces. 






= 


0032 


10 = 




6479 


1 = 


31 


103 


Ts 


= 


0040 


12 = 




7775 


2 = 


62 


206 




— 


0043 


15 = 




9718 


3 = 


93 


309 


T2 


= 


0054 


16 = 


1 


036 


4 = 


124 


41 


1 

To 


r= 


0065 


20 = 


1 


295 


5 = 


155 


51 


1 

g- 


= 


0081 


24 = 


1555 


6 == 


186 


61 


1 


= 


0108 


25 = 


1619 


7 = 


217 


72 


1 





0130 


30 = 


1 


943 


8 = 


248 


82 


1 

5 


= 


0162 


40 = 


2 591 


9 = 


279 


92 


1 


= 


0236 


50 = 


3 239 


10 = 


311 


03 


i 

2 


= 


0324 


60 = 


3 ( 887 


11 = 


342 


13 












Pounds. 














1 = 


373 


24 












2 = 


746 


49 












3 = 


1119 


72 



RELATION OF MEASURES OF THE U. S. PHARMACOPOEIA 
TO METRICAL MEASURES. 



One Gallon 
One Pint 
One Fluidounce 
One Fluidrachm 
One Minim 



3.785 Litres. 
4.273 Decilitres. 
2.957 Centilitres. 
3.697 Millilitres. 
0.061 Millilitre. 



WEIGHTS AND MEASURES. 



485 



RELATION OF METRICAL MEASURES TO MEASURES OF 
THE U. S. PHARMACOPCEIA. 

One Myrialtre = 2641.9 Gallons. 



One Kilolitre 
One Hectolitre 
One Decalitre 
One Litre 
One Decilitre 
One Centilitre 
One Millilitre 



= 264.19 



26.419 " 

2.641 " 

2.113 Pints. 

3.381 Fluidounces. 

2.705 Fluidrachms 
16.231 Minims. 



THE METRIC SYSTEM IN MEDICINE, 
For Prescription Writing. 



TT\j or gr. j equals 
f5J or3j » 



06 Gm. 



Tlie decimal line instead of points makes errors impossible. 

As .06 (Drug) is less than a grain, while 4. and 32. (Vehicle) 
are more than the drachm and ounce, there is no danger of giving 
too large doses of strong drugs. 

C.C. (cubic centimetres) used for Gms. (Grammes) causes an 
error of 5 per cent, (excess). 

A teaspoonful is usually 5 Gms. ; a tablespoonful 20 Gms. 



il 



THERAPEUTIC SUGGESTIONS; 

OB, 

INDEX OF DISEASES 

REFERRED TO IN THIS WORK. 



ABSCESSES 
alcohol, 128 

belladonna, 176 

cantharidal collodion, 242 

carbolic acid, 97 

cod-liver oil, 339 

flaxseed poultice, 323 

ice, 158 

iodine, 310 

sulphide of lime, 191 

yeast, 271 
Acne faciei 

sulphur, 423 
Acute mania 

belladonna, 176 

bromide of potassium, 386 

chloral, 211 

conium, 247 

dulcamara, 263 

hyoscyamus, 305 

Indian hemp, 1 96 

opium, 350 
Acute rheumatism 

arnica, 163 
After-pains (see Labor) 
Ague 

apiol, 467 

arsenic, 167 

chinolin, 237 

dogwood, 252 

eucalyptus, 456 

nectrandra, 334 

quinia, 232 

salicin, 470 
Ague-cake (see Spleen, enlarged) 



Albuminuria 

arsenic, 170 

benzoate of calcium, 184 

(See also Bright's disease) 
Alcoholism 

stopping supplies, 129 

tincture of capsicum, 201 
Amaurosis 

strychnia, 336 
Amenorrhea 

aloes, 138 

apiol, 467 

cantharides, 200 

catnep, 206 

cimicifuga, 226 

cotton-root bark, 288 

ergot, 267 

hedeoma, 291 

hellebore, 291 

hiera picra, 195 

iron, 274 

marjoram, 358 

myrrh, 333 

pennyroyal, 291 

rue, 399 

savin, 401 

ANiEMIA 

cod-liver oil, 340 
iron, 274 
phosphorus, 360 
solution of dialyzed iron, 463 
(See also Leucocythoemia) 
Aneurism 

ergotine injections, 265 
iodide of potassium, 388 



488 



INDEX OF DISEASES. 



Angina (see Sore throat) 
Angina pectoris 

hypodermic injection of mor- 
phia, 356 

nitrite of amyl, 447 

nitro- glycerin, 464 

opium, 352 
Animal-poisoning (see Poison- 
ing) 
Aphthous sore-mouth 

borax, 416 

chlorate of potassium, 380 

hyposulphite of sodium, 418 

sulphurous acid, 115 
Apoplexy 

croton oil, 346 
Arsenical poisoning (see Poison- 
ing) 

dialyzed iron, 165 
Ascarides (see Worms) 
Ascites (see Dropsy) 
Asthma 

aether, 125 

antimony, 152 

arsenic, 167 

atropia, 180 

belladonna, 180, 183 

chloral, 211 

chloroform, 219 

cod-liver oil, 340 

ether, 125 

eucalyptus globulus, 456 

ipecacuanha, 311 

lobelia, 324 

nitre papers, 382 

nitrite of amyl, 447 

nitro-glycerin, 464 

opium, 352 

pepsin, 466 

pilocarpin, 461 

quebracho, 469 

stramonium, 422 

tobacco-smoking, 427 

turpentine stupes, 429 
Atheroma 

digitalis, 259 



BILIARY COLIC (see Gall- 
stones) 
Biliousness 
acids, 56 



Biliousness — 

blue pill, 298 

ipecacuanha, 313 

nitro-muriatic acid, 110 

taraxcum, 428 

(See Hepatic disorders) 
Bites 

caustic potassa, 379 

excision, etc., 478 

nitrate of silver, 161 

(See also Poisoning) 
Bladder affections (see Cys- 
titis) 
Boils (see Abscesses) 
Bowel affections (see Diarrhoea 

and Constipation) 
Brain- affections 

blisters, 199 

bromide of potassium, 384 

croton oil, 346 

iodide of potassium, 388 

(See also Meningitis and Syph- 
ilis) 
Brain-softening 

phosphorus, 360 

zinc phosphide, 363 
Bright's disease 

alkalies, 381 

arsenic, 170 

benzoate of calcium, 184 

compound jalap powder, 316 

cream of tartar, 383 

diaphoretics, 71 

ergot, 266 

gallic acid, 280 

iron, 275 

jaborandi, 459 

pilocarpin, 461 

pipsissewa, 209 

potash salts, 381 

scoparius, 411 

water, 159 
Bromide-acne 

arsenic, 387 
Bronchitis 

aether, 125 

ammonia, 144, 145, 147 

ammoniac, 141 

antimony, 152 

arsenic, 167 

assafoetida, 172 

balsam of Peru, 174 



INDEX OF DISEASES. 



489 



Bronchitis — 

balsam of Tolu, 174 

benzoin, 184 

carbolic acid inhalations, 100 

chloride of ammonium, 144 

cod-liver oil, 338 

copaiba, 249 

corrosive sublimate, 297 

digitalis, 260 

eucalyptus, 436 

garlic, 137 

hydriodic acid, 890 

iodide of potassium, 390 

ipecacuanha, 312 

licorice mixture, 288 

linseed tea, 322 

lobelia, 324 

mist, glycyrrhizoe comp. 288 

mustard plasters, 415 

myrrh, 333 

oil of amber, 344 

opium, 352 

phosphoric acid, 112 

seneka, 412 

squill, 410 . 

steam, 158 

sulphur, 423 

tar, 370 

tartar emetic, 37 

turpentine, 429 

turpentine stupes, 429 

■wild-cherry bark, 394 
Bronchocele (see Goitre) 
Bronchopneumonia 

antimony, 152 

(See Bronchitis and Pneumo- 
nia) 
Bubo 

ice, 158 

(See also Abscesses) 
Burns 

bicarbonate of soda, 467 

carbolic acid, 97 

carbonate of lead, 372 

carbonate of soda, 418 

carron oil, 190, 322 

collodion, 289 

cosmoline, 467 

cotton, 289 

warm-bath, 158 



CALCULUS (phosphntic) 
nitric acid injections, 110 

potassa, 381 

(See also Gravel) 
Cancer 

acetic acid, 95 

arsenic, 167 

blood-root, 403 

chloride of zinc, 433 

chloroform, 221 

citric acid, 101 

iodoform, 310 

opium, 351 
Can c rum oris 

nitric acid, 110 
Cardiac disease (see Heart dis- 
ease) 
Cardiac dropsy (see Dropsy) 
Cardiac palpitation (see Heart 
disease) 

quebracho, 469 
Caries 

cod-liver oil, 340 

sulphuric acid, 114 
Catarrh (chronic) 

assafoetida, 172 

ipecacuanha, 313 

(See also Bronchitis and Co- 
ryza) 
Cerebral disorders (see Brain 

affections) 
Chafing (see Excoriation) 
Chancre (see Syphilis) 
Chapped hands 

collodion, 289 

glycerine, 287 
Chilblains 

tr. iodine, 309 
Chill (see Ague) 

alcohol, 132 
Chills and fever (see Ague) 
Chloasma 

sulphurous acid, 114 

(see also Skiu diseases) 
Chlorosis 

iron, 274 

solution of dialyzed iron, 403 

(see also Anaemia) 
Cholera 

cajuput oil, 189 

camphor, 194 

cold affusions, 157 



490 



INDEX OF DISEASES. 



Cholera — 

hypodermic injections of mor- 
phia, 857 

nitrite of amyl, 448 
Cholera infantum (see Diar- 
rhoea) 
Cholera morbus 

acetate of lead, 374 

opium, 353 

sulphuric acid, 1 14 

(see also Diarrhoea) 
Chordee 

camphor, 194 
Chorea 

aether, 125 

arsenic, 167 

belladonna, 182 

bromide of iron, 273 

bromide of potassium, 385 

chloral, 210 

chloroform, 221 

cimicifuga, 226 

cold affusion, 159 

conium, 245 

copper, 255 

ether-spray, 125 

iron, 273 

manganesium sulphate, 328 

oxide of zinc, 439 

physostigma, 365 

sulphate of zinc, 439 
Chronic mania 

cimicifuga, 226 

cod-liver oil, 339 

ergot, 265 

hemlock, 246 
Chronic nephritis (see Bright's 

disease) 
Cinchonism 

hydrobromic acid, 33 
Cirrhosis of kidneys 

chloride of gold and sodium, 459 
Cirrhosis of liver 

chloride of gold and sodium, 459 
Colds (see Coryza) 
Colic 

assafoetida, 172 

belladonna, 180 

cajuput oil, 189 

catnep, 206 

chloroform, 220 

cloves, 204 



Colic — 

ether, 125 

fennel tea, 278 

flaxseed poultices, 322 

ginger, 410 

mustard, 415 

oleum rnonarda), 331 

opium, 351 

pennyroyal, 291 

warm bath, 158 
Colica pictonum (see Painter 

colic) 
Color-blindness 

fuchsine, 457 

santonin, 405 
Condylomata 

acid nitrate of mercury, 295 

black-wash, 296 

carbolic acid, 98 

chromic acid, 100 

(See also Syphilis) 
Congestion of brain 

bromide of potassium, 385 

compound jalap powder, 316 

croton oil, 345 

elaterium, 264 
Congestion of spinal cord 

belladonna, 178 

ergot, 265 
Conjunctivitis 

alum, 140 

lard, 123 

silver nitrate, 161 

zinc sulphate, 439 
Constipation 

aloes, 138 

alum, 140 

assafoetida, 172 

belladonna, 180 

castor oil, 343 

colocynth, 244 

confection of senna, 205 

croton oil, 346 

elaterium, 264 

gamboge, 281 

jalap, 316 

juglans, 317 

leptandra, 319 

magnesii sulph. 114 

nux vomica, 335 

physostigma, 366 

picrotoxin, 453 



INDEX OF DISEASES. 



491 



Constipation — 

podophyllum, 375 

sambucus, 403 

seidlitz powders, 419 

senna, 413 

strychnia, 335 

sulphur, 424 

taraxacum, 428 
Consumption (see Phthisis) 
Contusions 

vinegar, 94 
Convulsions, epileptic (see Epi- 
lepsy) 
Convulsions, hysterical (see 

Hysteria) 
Convulsions, infantile 

assafoetida, 172 

bromide of potassium, 385 

chloral, 211 

chloroform, 220 

conia, 245 

ether, 123 

garlic, 137 

hemlock, 245 

mustard baths, 415 

oil of amber, 844 

warm bath, 158 
Convulsions, puerperal 

chloral, 210 

chloroform, 221 

veratrum viride, 43G 
Conyulsions, URiEMic(see Urtemic 

coma) 
Corns 

acetic acid, 95 

(See Warts) 

CORTZA 

aconite, 121 
alcohol, 131 
assafoetida, 172 
bismuth, 185 
boneset tea, 269 
camphor, 193 
creasote, 252 
cubebs, 253 
Dover's powder, 311 
glycerite of tannin, 280 
horehound, 329 
licorice, 288 
opium, 352 
Coug a 

belladonna, 182 



Cough — 

chloroform, 219 

gelsemium, 285 

hydrocyanic acid, 100 

opium, 352 

oxalate of cerium, 207 
Cracked nipples 

benzoin, 184 

collodion, 289 

tannic acid, 116 
Croup, pseudo-membranous 

alum, 140 

bromine, 388 

chlorate of potash, 380 

ipecacuanha, 313 

lactic acid, 107 

lime-water, 191 

steam, 158 

(See also Diphtheria, 
Spasm of the larynx) 
Croup, spasmodic 

alum, 140 

antimony, 152 
Cystitis 

buchu, 187 

copaiba, 249 

cubebs, 253 

hyoscyamus, 305 

iron, 275 

juniper, 317 

pareira,. 359 

turpentine, 431 

uva ursi, 434 



DEBILITY 
alcohol, 129 
cod-liver oil, 340 
gentian, 286 
iron, 275 
phosphorus, 359 
quinia, 230 
strychnia, 336 
(See also Anaemia) 
Delirium tremens 
antimony, 152 
arnica, 163 

bromide of potassium, 385 
chloral, 210, 214 
digitalis, 258 
hyo8cyamia, 305 
lupulin, 292 



ind 



492 



INDEX OP DISEASES. 



Delirium tremens — 

musk, 332 

opium, 349 

veratrum viride, 43G 
Diabetes 

almonds, 148 

bromide of potassium, 38G 

codeia, 357 

glycerine, 287 

opium, 353 

phosphoric acid, 112 

yeast, 271 
Diabetes insipidus 

ergot, 2G6 

jaboi'andi, 459 
Diarrhea 

acetate of lead, 373 

acids, 58 

alum, 140 

arsenic, 168 

bismuth, 186 

blackberry, 399 

cajuput oil, 189 

camphor, 194 

Castillon's powders, 431 

castor oil, 343 

catechu, 206 

chalk, 190 

cinnamon, 239 

copper, 255 

corrosive sublimate, 298 

ergot, 266 

geranium, 286 

gum arabic, 94 

ipecacuanha, 314 

kino, 318 

krameria, 318 

licorice, 288 

lime-water, 190 

logwood, 290 

nitrate of iron, 275 

opium, 352 

ox-bile, 457 

oxide of zinc, 439 

pepsin, 466 

podophyllum, 375 

resin, 396 

rhubarb, 398 

statice, 420 

sulphuric acid, 114 

tannic acid, 280 

testa proeparata, 431 



Diarrhcea — 

turpentine, 430 
Diphtheria and Diphtheritic 
croup 

ammonia, 144 

carbolic acid, 98 

chlorate of potassium, 383 

chlorine water, 217 

chromic acid, 100 

citric acid, 101 

ipecacuanha, 312 

lactic acid, 107 

lime inhalations, 190 

muriatic acid, 108 

tincture of iron, 275 

turpentine, 430 
Diphtheritic paralysis 

strychnia, 336 

tartar emetic, 152 
Dislocations 

chloroform, 221 

hemlock, 246 
Drink-craving 

tincture of capsicum, 201 
Dropsy 

blisters, 199 

citrate of caffein, 188 

comp. jalap powder, 316 

copaiba, 250 

cream of tartar, 381 

digitalis, 261 

elaterium, 264 

erigeron, 269 

gamboge, 281 

juniper, 317 

pilocarpin, 461 

potash salts, 381 

scammony, 409 

scoparius, 411 

squill, 410 

spirits of nitre, 136 
Dysentery 

camphor, 194 

ergot, 266 

gum arabic, 94 

Indian bael, 450 

ipecacuanha, 314 

opium, 352 

rhatany, 318 
Dysmenorrhea 

chloride of gold, 460 



INDEX OF DISEASES. 



493 



Dyspepsia 
acids, 56 
aloes, 138 
arsenic, 168 
assafoetida, 172 
belladonna, 182 
bismuth, 185 

bromide of potassium, 386 
carbolic acid, 100 
chamomile, 149 
charcoal, 202 
columbo, 192 
emetics, 74 
gentian, 286 
gold, 459 
hydrastus, 304 
hydrocyanic acid, 104, 106 
lactic acid, 107 
lime-water, 191 
magnesia, 326 
muriatic acid, 108 
nux vomica, 337 
ox-bile, 457 
pepsin, 465 
picrotoxin, 453 
quassia, 395 
quebracho tincture, 468 
quinia, 230 
rhubarb, 397 
senna, 413 
soda, 419 
soda-mint, 419 
sulphate of manganese, 328 
sulphurous acid, 115 
taraxacum, 428 
thoroughwort, 269 



EAR DISCHARGES 
boracic acid, 441 
Eczema 

arsenic, 169 

bicarbonate of potassium, 379 
chloral, 209 

glycerite of tannic acid, 281 
hydrocyanic acid, 103 
lead-water, 372 
phosphorus, 361 
soda, 418 

spiritus saponis kalinis, 407 
thymol, 471 

(See also Skin diseases) 
42 



Emphysema 

quebracho, 409 
Empyema 

tr. iodine, 309 
Epilepsy 

belladonna, 182 

bromide of ammonium, 147 

bromide of potassium, 384, 387 

Calabar bean, 365 

copper, 255 

nitrite of amyl, 446 

nitro-glycerin, 464 

picrotoxin, 453 

silver, 162 
Epistaxis 

ergot, 265 

iron, 272 

(See Hemorrhage) 
Erysipelas 

aconite, 120 

collodion, 242, 289 

elm-poultice, 433 

lead-^ater, 372 

liquor gutta-percha, 290 

nitrate of silver, 162 

quinia, 229 

sulphate of iron, 273 

tincture of iron, 275 
Excoriations 

bismuth, 185 

chalk, 190 

lycopodiura, 326 

spermaceti cerate, 208 

starch 148 

(See Skin diseases) 

FACIAL NEURALGIA 
aconite, 119 

gelsemium, 283 

(See also Neuralgia) 
Fainting (see Syncope) 
Fatigue 

alcohol, 129 

coca leaves, 189 
Favus 

black-wash, 290 

(See Skin diseases) 
Felon 

carbolic acid, 98 
I Fetid expectoration 

creasote, 252 



494 



INDEX OF DISEASES. 



Fetid expectoration — 

salicylic acid, 443 
Fetid perspiration 

ointment of boracic acid, 441 
Fever, intermittent (see Ague) 
Fevers 

acids, 57 

aconite, 120 

althea, 139 

baths, 157 

digitalis, 261 

effervescing draughts, 101 

gum arabic, 94 

liquor ammonii acetatis, 146 • 

quinia, 230 

salicylic acid, 443 

tartaric acid, 117 

vinegar, 94 
Fissure of rectum 

belladonna, 176 
Flatulence 

aether, 125 

carbolic acid, 100 

charcoal, 202 

cloves, 204 

fennel, 278 

oleum hedeoma, 291 

soda-mint, 419 

sulphurous acid, 115 

(See also Dyspepsia) 
Flooding, post-pactum 

ergot, 267 

iron injections, 272 

(See also Haemorrhage) 



GALL-STONES 
belladonna, 182 
chloroform, 221 
hypodermic injections of mor- 
phia, 357 
opium, 351 
warm bath, 158 
Gastralgia 
blisters, 199 

manganesium sulphate, 327 
silver nitrate, 162 
(See also Colic) 
Gastro Enteric inflammation 
gum arabic, 94 

(See also Diarrhoea and Dysen- 
tery) 



Gleet 

copper sulphate, 255 

iron, 275 

styrax, 422 

turpentine, 431 

(See also Gonorrhoea) 
Goitre 

biniodide of mercury, 296 

tincture of iodine, 309 
Gonorrhoea 

alum, 140 

aluminii sulphas, 141 

bismuth, 185 

buchu, 187 

copaiba, 249 

cubebs, 253 

fluid extract of matico, 329 

hydrastis canadensis, 304 

infusion of pomegranate, 394 

silver nitrate, 161 

styrax, 4 1:2 

sulphate of copper, 255 

sulphate of zinc, 439 

tannic acid, 279 

turpentine, 430 
Gout 

colchicum, 240 

iodide of potassium, 390 

lithium, 323 

potash, 380 

salicylic acid, 443 
Granular lids 

sulphate of copper, 255 
Gravel 

lithia, 323 

salicylate of soda, 443 



H^MATEMESIS 
gallic acid, 280 
(See also Haemorrhage) 

HEMATURIA 

turpentine, 430 

HEMOPTYSIS 

acetate of lead, 373 
alum, 140 
atropia, 179 
digitalis, 259 
ergot, 266 
gallic acid, 280 

HAEMORRHAGE 

acetate of lead, 373 



INDEX OF DISEASES. 



405 



HEMORRHAGE — 

alum, 140 

collodion, 289 

digitalis, 259 

ergot, 265 

erigeron, oil of, .269 

ice, 158 

iron, 272 

matico, 329 

opium, 352 

taunic acid, 279 

turpentine, 430 

(See also Menorrhagia, etc.) 
Hemorrhoids 

belladonna, 176 

charcoal, 203 

ergot, 265 

glycerine, 287 

iodoform, 310 

ointment of galls, 2^0 

opium fomentations, 349 

nitric acid, 110 

pepper, 368 

stramonium, 422 

sulphur, 424 
Hay-asthma or hay-fever 

arsenic, 167 

quinia, 231 
Headache 

aconite, 119 

nitro-glycerine, 464 

podophyllum, 375 

tincture of mix vomica, 337 

valerian, 435 

valerianate of ammonia, 117, 
435 

vinegar, 94 

(See also Neuralgia) 
Heartburn 

magnesia, 326 

soda mint, 419 

(See also Dyspepsia) 
Heart-clot 

ammonia, 144 
Heart-disease 

aconite, 120 

aether, 125 

belladonna, 178 

comp. jalap powder, 316 

digitalis, 258 

hydrocyanic acid, 104 

morphia, 352 



Heart-disease — 

potash-salts, 381 

scoparius, 411 

veratrum viride, 436 
Hepatic disorders 

ammonii chloridum, 146 

blue pill, 298 

citric acid, 101 

ipecacuanha, 314 

leeches, 472 

nitric acid, 110 

nitro-muriatic acid, 111 

podophyllum, 375 

rhubarb, 397 

sodii bicarbonas, 418 
Hernia 

chloroform, 221 

hemlock, 246 

tartar emetic, 152 

warm bath, 158 
Herpes zoster 

collodion, 242 

(See Skin diseases) 
Hiccough 

musk, 332 

oil of amber, 344 
Hydrocele 

tr. iodine, 309 
Hydrophobia 

woorara, 453 
Hydrothorax 

pilocarpin, 462 

scoparius, 411 

(See also Pleurisy) 
Hyperpyrexia 

quinia, 230 

resorcin, 470 

salicylic acid, 443 
Hypochondriasis 

cimicifuga, 226 

(See Acute and Chronic ma- 
nia) 
Hysteria 

astber, 125 

assafcetida, 172 

catnep, 206 

chloroform, 219 

cloves, 204 

cold water, 151 

hemlock, 246 

musk, 332 

oil of amber, 344 



496 



INDEX OF DISEASES. 



Hysteria — 
valerian, 435 
valerianate of zinc, 117 
valerianates, 117 



IMPACTION OF FECES 
seidlitz powders, 419 

(See Constipation) 
Impetigo 

arsenic, 169 

(See Skin diseases) 
Impotence 

phosphorus, 360 
Incontinence of urine 

belladonna, 37, 180 

bromide of potassium, 385 

buchu, 188 

chloral, 211 

collodion, 242 

ergot, 266 

santonin, 406 

strychnia, 336 
Indigestion 

ipecacuanha, 314 

(See Dyspepsia) 
Infantile convulsions (see Con- 
vulsions, infantile) 
Inflammations 

alcohol, 130 
Insanity (see Acute and Chronic 

mania) 
Insomnia 

aconitia, 123 

chloral, 210 

napeline, 123 

opium, 349 
Intermittent fever (see Ague) 
Intertrigo 

bismuth, 185 

(See Excoriation) 
Intestinal obstruction 

(See Obstruction of bowels) 
Iritis 

atropia, 177 

blisters, 198 

leeches, 472 
Irritable heart (see Heart 

disease) 
Irritable stomach (see Vomit- 
ing) 
Itch (see Scabies) 



JAUNDICE 
podophyllum, 375 
rhubarb, 397 
sanguinara, 403 
soda, 418 

(See also Hepatic disorder) 
Joint-affections 
blisters, 198 
cod-liver oil, 340 
digitalis, 257 
iodine, 309 
oleate of mercury, 296 



K 



IDNEY COMPLAINT 

comp. jalap powder, 316 
copaiba, 250 
digitalis, 261 
gallic acid, 280 
iron, 275 
pipsissewa, 209 
potash salts, 381 
(See also Bright's disease) 



LABOR 
chloral, 211 

chloroform, 221 

cotton-root bark, 289 

ergot, 265 

opium, 351 

quinia, 228 
Laryngismus stridulus (see 

Spasm of the larynx) 
Leprosy 

copaiba, 249 

(See Skin diseases) 
Leucocythemia 

phosphorus, 360 

(See also Anosmia) 
Leucorrhcea 

alum, 140 

aluminii sulphas, 141 

bismuth, 185 

ergot, 267 

fluid extract matico, 329 

iron injections, 273 

lime-water, 190 

matico, 329 

sulphate of zinc, 439 

tannic acid, 279 

white-oak bark, 395 



INDEX OF DISEASES. 



407 



Lichen 

arsenic, 169 

(See Skin diseases) 
Lithiasis 

boracic acid, 442 
Liver disease (see Hepatic dis- 
orders) 
Locomotor ataxia 

silver oxide, 162 
Lumbago (see Myalgia) 
Lumbricoids (see Worms) 
Lupus 

arsenic, 167 

carbolic acid, 97 

copaiba, 249 

(See Skin diseases) 



MALARIAL FEVERS 
(See Ague) 
Mania (see Acute or Cbronic 
mania) 

arnica, 163 
Mastitis 

belladonna, 181 
Mastodynia 

belladonna, 181 
Measles 

phosphorus, 361 
Meningitis 

blisters, 199 

ice, 158 

opium, 350 
Menorrhagia 

atropia, 179 

bromide of potassium, 386 

cinnamon, 239 

digitalis, 259, 262 

ergot, 265 

erigeron, 269 

gallic acid, 280 

oil of erigeron, 269 

oxide of silver, 162 

(See also Haemorrhage) 
Mental failure 

chloride of gold, 459 
Migraine (see Neuralgia) 
Mitral disease (see Heart dis- 
ease) 
Myalgia 

ammonium chloride, 144 

atropia injections, 182 



Myalgia — 

boneset tea, 269 

chloroform, 219 

cimicifuga, 226 

gelsemium, 283 

morphia injections, 356 

mustard plasters, 415 
Myelitis, chronic 

belladonna, 181 



\TARCOTIC POISONING 
IN blisters, 198 

(See also Poisoning) 
Necrosis 

sulphuric acid, 114 
Nervous debility 

iron, 273 

phosphorus, 359 

strychnia, 336 

(See also Debility) 
Nervous headache 

citrate of caffein, 188 

Indian hemp, 196 

valerian, 435 

valerianate of ammonia, 435 

(See also Headache) 
Nervous insomnia 

chloral, 210 

musk, 332 

(See also Insomnia) 
Nervousness 

assafoetida, 172 

camphor, 193 

valerianates, 136 

(See Hysteria) 
Neuralgia 

aconite, 120, 122 

aconitine, 128 

aether, 125 

alcohol, 129 

ammonium chloride, 144, 147 

apiol, 467 

arsenic, 167 

belladonna, 176 

blisters, 198 

cannabis Indica, 196 

chloral, 209 

chloral-camphor, 215 

chloroform, 219 

cochineal, 239 

cod-liver oil, 339 



42* 



J 



498 



INDEX OF DISEASES. 



Neuralgia — 

croton-chloral, 216 

gelsemium, 283 

guarana, ISO 

hydrocyanic acid, 103 

hypodermic injections of mor- 
phia, 356 

Indian hemp, 196 

iodoform, 310 

iron, 273 

mustard-plaster, 415 

napeline, 123 

nitrite of amyl, 447 

oil of peppermint, 331 

opium, 351 

phosphide of zinc and nux vo- 
mica, 363 

quinia, 230 

salicin, 470 

turpentine stupes, 430 

valerianate of quinia, 117 

veratria ointment, 400 

(See also Headache, Toothache, 
Myalgia, and Pleurodynia) 
Night sweats 

acetic acid, 95 

atropia, 181 

ergot, 265 

oxide of zinc, 439 

quinia, 231 

sulphuric acid, 114 
Nipples, soke (see Cracked nip- 
ples) 



OBSTRUCTION OF BOWELS 
acetate of lead, 374 

belladonna, 180 
(Edema (see Dropsy) 
(Edema of glottis 

chromic acid, 100 
Onychia maligna 

nitrate of lead, 372 
Ophthalmia (see Conjunctivitis) 
Opium habit 

avena, 173 
Orchitis 

ice, 158 

leeches, 472 
Otorrhoea 

glycerite of tannic acid, 280 



Oxyuris vermicularis (see 
Worms) 

Oz.ENA 

creasote, 252 

glycerite of tannic acid, 280 
potassium permanganate, 379 
(See also Coryza) 



PAINTERS' COLIC 
alum, 140 

belladonna, 180 

chloroform, 219 

Epsom salt, 326 

iodide of potassium, 390 

sulphuric acid, 114 
Palpitation of the heart 

belladonna, 178 

chloroform, 219 

digitalis, 258 

opium, o52 

(See also Heart disease) 
Paralysis 

ergot, 265 

strychnia, 336 
Paralysis agitans 

hemlock, 246 
Paraplegia (see Paralysis) 
Parturition (see Labor) 
Pediculi 

black wash, 296 
Pemphigus 

arsenic, 169 
Pericarditis 

blisters, 199 

leeches, 472 

mercury, 299 
Periostitis 

iodide of potassium, 389 
Peritonitis 

aconite, 120 

blisters, 199 

flaxseed poultices, 322 

leeches, 472 

mustard, 415 

opium, 351 

turpentine stupes, 429 
Phagedena 

chromic acid, 100 

iron, 273 

nitric acid, 110 



INDEX OF DISEASES. 



499 



Phagedena — 

quinia, 229 
Phtiiims 

arsenic, 167 

chloral, 210 

cod-liver oil, 310 

hypophosphite of lime, 191 

lactucarium, 319 

opium, 352 

oxalic acid, 112 

wild-cherry bark, 394 
Phthisis, cough 

codeia, 357 

picrotoxine, 452 
Phthisis, diarrhoea 

quebracho tincture, 468 
Phthisis, fever 

salicin, 470 
Phthisis, sweating 

muscarin, 464 

(See also Night-sweats) 
Pityriasis capitis 

chloral, 210 

calomel ointment, 299 
Pleurisy 

aconite, 120 

blisters, 198 

leeches, 472 

mustard, 415 

pilocarpin, 461 

turpentine stupes, 429 
Pleurodynia 

blisters, 198 

iodine, 309 

mustard, 415 

(See also Neuralgia) 
Pneumonia 

aconite, 120 

ammonia, 144, 145 

antimony, 152', 154 

blisters, 199 

diaphoretics, 70 

flaxseed poultices, 322 

iodine, 309 

mercury, 299 

mustard, 415 

opium, 351 

quinia, 229 

senega, 412 

turpentine stupes, 429 

veratrum viride, 437 



Podagra (see Gout) 
Polypi, uterine 

ergot, 267 

(See also Menorrhagia) 
Polyuria (see Diabetes insipidus) 

POST-PARTUM HEMORRHAGE 

iron, 272 

iodine (see also Hemorrhage) 
Priapism 

bromide of potassium, 386 

camphor, 193 
Prolapsus ani 

bismuth, 185 
Pruritus 

calomel ointment, 299 

chloral-camphor, 215 

hydrocyanic acid, 103, 106 

soda, 418 

tobacco, 426 

(See also Skin diseases) 
Psoriasis 

antimony, 153 

arsenic, 169 

cantharides, 200 

chrysophanic acid, 458 

copaiba, 249 

Goa powder, 458 

phosphorus, 361 

tar ointment, 370 

thymol, 471 
Puerperal convulsions (see Con- 
vulsions) 
Pulmonary complaints 

Iceland moss, 208 

(See Phthisis, Pneumonia, and 
Pleurisy) 
Purpura 

arsenic, 169 

ergot, 265 

turpentine, 429 

(See also Scurvy) 
Pyjsmia 

alcohol, 131 

quinia, 229 
Pyelitis 

cantharides, 200 

turpentine, 429 
Pyrdsjs 

bismuth, 186 

magnesia, 326 

manganesium sulphate, 328 



500 



INDEX OF DISEASES. 



Pyrosis — 

soda mint, 419 
sulphurous acid, 115 
(See also Dyspepsia) 



Q 



UINSY (see Tonsillitis) 



RACHITIS 
cod-liver oil, 340 

iron, 274 

lacto-phospbate of lime, 191 

phosphoric acid, 112 

phosphorus, 362 
Renal calculus 

chloroform, 221 

opium, 352 

warm bath, 158 

(See also Calculus) 
Rheumatism 

aconite, 120 

arsenic, 169 

baths, 157 

belladonna, 176, 182 

blisters, 199 

bromide of ammonium, 144 

chloral, 210 

cimicifuga, 226 

citric acid, 101 

cod-liver oil, 342 

cotton-wadding, 289 

Dover's powder, 315 

guaiac, 290 

iodide of potassium, 390 

iron, 275 

lemon-juice, 321 

oil of cajuput, 189 

oil of monarda, 331 

pilocarpin, 461 

pipsissewa, 209 

potassium salts, 380 

quinia, 229 

salicin, 470 

salicylic acid, 442 

sulphur, 423 

trimethylamine, 471 

(See also Myalgia) 

RnEUMATOID ARTHRITIS 

arsenic, 169 
guaiac, 290 



Rickets (see Rachitis) 
Ringworm 

acetic acid, 95 

croton oil, 346 

thymol, 471 

(See also Skin diseases) 
Rupture of bladder 

opium, 351 
Rupture of intestine 

opium, 351 
Rupture of uterus 

opium, 351 



OALIVATION 
U belladonna, 180 
chlorate of potash, 380 

SARCINOUS VOMITING: 

carbolic acid, 100 

eucalyptus, 456 

hyposulphite of soda, 418 

sulphurous acid, 115 

(See also Vomiting) 
Scabies 

arsenic, 169 

storax, 422 

sulphur ointment, 423 
Scarlet fever 

aconite, 120 

ammonii carbonas, 146 

belladonna, 182 

chlorate of potassium, 380 

chlorine water, 218 

phosphorus, 361 

quinia, 229 
Sciatica 

atropia injections, 182 

blisters, 198 

hypodermic injections of mor- 
phia, 357 

mustard, 415 

opium, 351 

turpentine enema, 430 

(See also Neuralgia) 
Scorbutus (see Scurvy) 
Scrofula 

barium chloride, 174 

calcium chloride, 191 

cod-liver oil, 341 

comp. tinct. of iodine, 309 

iodine, 309 

iron, 274 



INDEX OF DISEASES. 



501 



Scrofula — 

phosphoric acid, 112 

pipsissewa, 209 

stillingia, 421 
Scurvy 

chromic acid, 100 

citric acid, 101 

lemon-juice, 320 

oxalic acid, 112 

vinegar and nitre, 94 
Sea-sickness 

bromide of potassium, 386 

chloral, 211 

chloroform, 219 
Sick-headache (see Headache) 
Seminal emissions 

belladonna, 177 
Skin diseases 

acetic acid, 95 

antimony, 153 

arsenic, 169 

bismuth, 185 

black-wash, 296 

cadmium salts, 188 

carbolic acid, 97 

chloral, 209 

chloroform, 219 

chrysophanic acid, 458 

cod-liver oil, 342 

collodion, 242 

copaiba, 248 

creasote, 252 

dulcamara, 263 

Goa powder, 458 

hydrocyanic acid, 103 

hyposulphite of soda, 418 

iodine, 309 

lycopodium, 326 

mercurial ointment. 296 



nitrate of lead, 372 



438 



oxide of zinc ointment, 

phosphorus, 361 

sapo viridis, 407 

soda, carbonate of, 418 

starch, 148 

stillingia, 421 

sulphur baths, 423 

sulphurous acid, 115 

tar ointment, 370 

thymol, 471 

warm bath, 158 

(See Acne faciei, Eczema, Ery- 



Skin diseases — 

sipelas, Excoriations, Favus, 
Herpes zoster, Impetigo, Le- 
prosy, Lichen, Lupus, Ony- 
chia maligna, Pemphigus, 
Prurigo, Psoriasis, Ring- 
worm, Scabies, Smallpox, and 
Tinea Tonsurans) 
Skin diseases, chronic 

jaborandi, 461 
Sloughing 

nitric acid, 110 
Smallpox 

alcohol, 131 

quinia, 231 
Smallpox pitting 

collodion, 242 

liquor gutta perch se, 290 

mercurial oiutment, 296 

silver nitrate, 161 
Snake-bite 

ammonia, 143, 146 
Sore throat 

alum, 140 

chlorate of potash, 383 

compound infusion of roses, 
398 

corrosive sublimate, 296 

glycerite of tannic acid, 280 

gum arabic, 94 

iodoform, 310 

iron, 273 

myrrh, 333 

rosemary, 420 

sage tea, 402 

tannic acid, 280 

(See also Tonsillitis) 
Spasm of the larynx 

antimony, 152 

bromide of potassium, 385 

cold affusions, 157 

compound syrup of squill, 410 

conium, 246 
Spasmodic stricture 

(See Stricture) 
Spinal sclerosis 

nitrate of silver, 162 
Spleen, enlarged 

conium, 246 

fluid extract of ergot, 266 

opium, 351 

quinia, 232 



502 



INDEX OF DISEASES. 



Sprains and bruises 

laudanum, 349 

lead-water, 372 

vinegar, 94 
Stings of insects 

ammonia, 143 
Stomatitis 

bismuth, 185 

chromic acid, 100 
Stone in the bladder (see Cal- 
culus) 
Stricture, spasmodic 

hemlock, 246 

iron, 274 

opium, 351 

warm bath, 158 
Struma (see Scrofula) 
Stupor (see Uraemic coma and 

Narcotic poisoning) 
Suffocative catarrh (see Bron- 
chitis) 
Summer complaint (see Diar- 
rhoea) 
Sunburn 

vinegar, 94 
Sunstroke 

cinchona, 230 
Suppurating glands (see Scro- 
fula) 
Sweating 

acids, 56 

alum, 140 

atropia, 181 

belladonna, 176 
Sweating of phthisis (see Night- 
sweats) 
Syncope 

ammonia, 143 
Syphilis 

bichromate of potassium, 384 

black-wash, 296 

chromic acid, 100 

cod-liver oil, 342 

corrosive-sublimate injections, 
302 

guaiac, 290 

iodide of potassium, 390 

iron, 273 

mercury, 297, 299 

nitric acid, 110 

sarsaparilla, 356 

stillingia, 421 



Syphilis — 

Zittmann's decoction, 304 
Syphilitic brain-disease 

mercury, 299 
Syphilitic sore-throat 

black-wash, 299 

corrosive sublimate gargle, 302 

silver nitrate, 161 

sulphate of copper, 254 
Syphilitic ulcer 

acid nitrate of mercury, 296 

iodoform, 310 

nitrate of silver, 161 

sulphate of copper, 254 

sulphuric acid, 114 



TiENIA (see Worms) 
Tapeworm (see Worms) 

pelletierine, 394 
Tetanus 

bromide of potassium, 385 

cannabis Indica, 196 

chloral, 211 

conium, 246 

curare, 453 

eserine, 367 

gelsemium, 284 

nitrite of amyl, 446 

physostigma, 365 

tobacco, 426 

woorara, 453 
Tinea tonsurans 

black-wash, 296 

carbolic acid, 98 

iodine, 309 

sulphurous acid, 115 

(See also Skin diseases) 
Tinea versicolor 

sulphurous acid, 115 
Tinea circinata 

Goa powder, 458 
Tonsillitis 

aconite, 120 

capsicum-gargle, 201 

steam, 158 
Tonsils, enlarged 

chromic acid, 101 
Toothache 

atropia, 182 

cajuput oil, 189 

creasote, 252 



INDEX OF DISEASES. 



503 



Toothache — 

oil of cloves, 204 
Torticollis 

conium, 246 
Trismus 

hemlock, 246 

(See also Tetanus) 
Trismus nascentium 

chloral, 211 
Tympanitis 

assafoetida, 172 

turpentine, 430 
Typhoid condition 

alcohol, 131 

ammonia, 145 

phosphorus, 360 
Typhoid fever 

alcohol, 131 

ammonia, 145 

digitalis, 260 

ergot, 265 

muriatic acid, 108 

opium, 349 

quinia, 229 

turpentine, 430 

veratrum viride, 437 
Typhus 

alcohol, 131 

antimony, 151, 154 

blisters, 198 

chloral, 210 

chlorine-water, 218 

opium, 349 

quinia, 229 



ULCERATED SURFACES 
bismuth, 195 

carbolic acid, 97 

silver nitrate, 161 
Ulcers 

acid nitrate of mercury, 296 

carbolic acid, 97 

charcoal poultices, 202 

chromic acid, 100 

copper sulphate, 254 

iodoform, 310 

nitrate of silver, 161 

potassium permanganate, 379 

yeast poultice, 271 
UR2EMIC coma 

cathartics, 81 



Uremic coma — 

croton oil, 343 

diaphoretics, 71 

diuretics, 72 

mustard poultices, 416 
Uterine cancer 

iodoform, 310 

(See Cancer) 
Uterine polypi 

ergot, 267 



VARICOSE VEINS 
ergot, 266 
Vesical catarrh 

buchu, 187 

(See Cystitis) 
Vesical irritations 

benzoin, 184 

hyoscyamus, 305 

pareira, 359 
Vesical irritability 

iron, 275 

sodium bicarbonate, 418 

(See Calculus) 
Vomiting 

arsenic, 169 

bismuth, 185 

carbolic acid, 100 

creasote, 252 

dilute hydrocyanic acid, 104 

ice, 158 
Vomiting, persistent 

calomel, 36, 297 

chloroform, 219 

effervescing draught, 101 

gray powder, 36, 297 

ice, 158 

ipecacuanha, 36, 312 

seidlitz powders, 419 

(See also Sarcinous vomiting) 
Vomiting of pregnancy 

aconite, 121 

bromide of potassium, 386 

ingluvin, 458 

ipecacuanha, 36, 312 

oxalate of cerium, 207 

tincture of nux vomica, 337 



w 



ARTS 

acetic acid, 95 



504 



INDEX OF DISEASES. 



Warts— 

bichromate of potassium, 383 

chromic acid, 100 

nitric acid, 110 

silver nitrate, 161 
Whooping-cough 

alum, 140 

antimony, 152 

assafoetida, 172 

belladonna, 181 

bromide of ammonium, 147 

bromide of potassium, 385 

camphor, 194 

carbolic acid, 100 

chloral, 210 

chloroform, 219 

cochineal, 239 

cod-liver oil, 339 

ergot, 266 

hydrocyanic acid, 104 

oil of amber, 344 

quinia, 230 

squill, 410 
Winter-cough 

(See Bronchitis) 
Worms (for general remarks on 
Anthelmintics see page 59) 

Ascaris lumbricoides (Round 
worms) 
azedarach, 450 



Worms — 

oil of worm-seed, 208 

santonin, 405 

scammony, 409 

spigelia, 419 

turpentine, 430 
Oxyuris vermicularis (Seat- 
worms) 

enemata of iron, 273 

enemata of lime-water, 190 

enemata of quassia, 395 

enemata of viuegar, 94 
Tsenia (Tape-worms) 

carbolic acid, 100 

filix mas, 278 

infusion of pomegranate, 394 

kamala, 470 

kousso, 450 

pelletierine, 394 

pumpkin seeds, 359 

rottlera, 470 

turpentine, 430 
Trichina spiralis 

general treatment, 60 
Wrist- drop 
strychnia, 336 
(See Lead-poisoning) 
Wry-neck 
hemlock, 246 
(See Myalgia) 



GENERAL INDEX 



ABSINTHE, 93 
Absinthium, 93 
Acacia, 93 
Accumulation of arsenic, 170 

of digitalis, 2(52 

of medicine, 41 

of strychnia, 337 
Aceta, 96 
Acetic acid, 94 
Acetum, 94 

destillatum, 94 

lobeliae. 324 

opii, 347 

sanguinarias, 403 

sciHse, 409 
Acida, 117 

Acid, chrysophanic, 458 
Acids in biliary derangement, 57 

disadvantages of, 58 

effect on circulation, 55 

effects on secretion, 56 

effects on temperature, 56 

effects on the urine, 57 

external effects, 55 

internal effects, 55 

officinal, 117 

poisonous effects of, 58 

remarks on, 55 

stimulating alkaline secretions, 
57 
Acidum aceticum, 94 

aceticum dilutum, 94 

arseniosum, 96, 164 

benzoicum, 184 

boracicum, 441 

carbolicum, 96 
impurum, 96 

cbromicum, 100 

citricum, 101 

gailicum, 279 

hydrocyanicum dilutum, 102 

lacticum, 107 
43 



Acidum — 

muriaticum, 107 
dilutum, 107 

nitricum, 109 
dilutum, 109 

nitro-muriaticum, 110 
dilutum, 110 

oxalicum, 111 

phosphoricum dilutum, 112 
glaciale, 112 

salicylicum, 442 

sulphuricum, 112 
aromaticum, 112 
dilutum, 112 

sulphurosum, 115 

tannicum, 115, 279 

tartaricum, 116 

valerianicum, 117 
Acne from bromides, 387 

prevented by arsenic, 33 
Aconite, 118 

in fever, 30, 118 

leaves, 118 

root, 118 
Aconitia, 118 
Aconiti folia, 118 

radix, 118 
Aconitum, 118 
Action of drugs changed with 

dose, 36 
Adeps, 123 
Administration, forms of, 28, 34 

of aconite, 122 

of antimony, 154 

of opium, 356 

of purgatives, 80 

of quinia, 234 
.Ether, 124 

fortior, 124 
JEtherea, 127 
Alcohol, 127 

amylicum, 136 



506 



GENERAL INDEX. 



Alcohol — 

dilutum, 127 

fortius, 127 
Alcohol as food, 133-134 

amount of, iu liquors, 135 
Alkaloids in cinchona, 236 
Allium, 136 
Allspice, 368 
A'mond, 147 

as food in diabetes, 148 

mixture, 147 
Aloe, 137 

Barbadensis, 137 

Capensis, 137 

compound decoction of, 139 

purificata, 137 

Socotrina, 137 
Aloes, 137 
Althsea, 139 
Alum, 139 
Alumen, 139, 141 

exsiccatum, 135 
Aluminii et potassii sulphas, 141 

sulphas, 141 
Amber, 344 

Amblyopia from tobacco, 426 
American hellebore, 435 

leeches, 472 

pennyroyal, 291 
Ammonia, 141 
Ammoniac, 141 
Ammoniacum, 141 
Ammoniated copper, 253 

mercury, 142 
Ammonii benzoas, 142, 184 

bromidum, 142, 186 

carbonas, 142 

chloridum, 142 

chloridum purificatum, 142 

iodidum, 142 

nitras, 142 

salicylas, 442 

sulphas, 142 

valerianas, 117, 136 
Ammonio-ferric alum, 142 
Ammonio-tartrate of iron, 142 
Amygdala, 147 
Amygdala amara, 147 

dulcis, 147 
Amyl nitris, 445 
Amylic alcohol, 136 
Amylum, 148 



Anaesthesia by chloroform, 220 

by chloral, 210 

by ether, 126 

by ethidene, 451 

by ethyl bromide, 451 

by nitrous oxide gas, 465 
Ansesthetic, local, 97 
Anaesthetics, 58 

choice of, 58 
Angustura, 148 
Anise, 149 
Anise-seed, 149 
Anisum, 149 
Anthelmintics, 59 

how to give, 36, 61 
Anthemis, 149 
Antidote, acetic acid, 95 

aconite, 118 

alcohol, 128 

ammonia, 143 

arsenious acid, 165 

barium, 174 

belladonna, 175 

bitter almond, 148 

bromine, 187 

camphor, 193 

carbolic acid, 97 

chemical, 62 

chloral, 212 

conia, 245 

copper, 254 

corrosive poisoning, 295 

corrosive sublimate, 295 

digitalis, 257 

Fowler's solution, 165 

general, for poisons, 472 

hydrocyanic acid, 102, 105 

iodine, 308 

lead, 371 

lobelia, 324 

muriatic acid, 108 

nitrate of silver, 161 

nitric acid, 109 

oil of bitter almonds, 148 

opium, 348 

oxalic acid, 111 

phosphorus, 359 

physiological, 62 

physostigma, 364 

potassa, 378 

stramonium, 421 

strychnia, 335 






GENERAL INDEX. 



507 



Antidote — 

sulphuric acid, 1 1 3 

tartar emetic, 151 

tartaric acid, 116 

tobacco, 425 

veratria, 400 

zinc, 438 
Antidotes, theory of, 61 
Antimouial powder, 153 

wine, 153 
Antimonii et potassii tartras, 149 

et potassi tartras, toleration of, 
40 

oxidurn, 149 

oxysulphuretum, 150 

sulphuretum, 149 
Antimonium, 149 

sulphuratum, 150 
Antimony, 149 

Antipyretics and refrigerants. 63 
Antiseptic system of Lister, 98 
Antiseptics, action of, 66 

and disinfectants, 66 

properties of charcoal, 202 
of chloral, 209 
of iodine, 309 
Apiol, 467 

Apollinaris water, 160 
Apomorphia, 357 
Aqua, 155 

acidi carbolici. 96 

acidi carbonici, 160, 329 

ammonias, 142 

ammonite fortior, 141 . 

amygdalae amarse, 147 

anisi, 149 

aurantii florum, 172 

camphorae. 193 

chlorini, 217 

cinnamomi, 239 

creasoti, 252 

destillata, 155 

fceniculi, 278 

laurocerasi, 463 

menthae piperitae. 330 

menthae viridis, 330 

rosae, 398 
Aquae, 160 
Araroba, 458 
Areca nut, 449 
Argenti cyanidum, 102, 160 

nitras, 160 



Argenti — 

nitras fusa, 101 

oxidum, 101 
Argentum, 160 
Arnica, 162 
Arrowroot, 328 
Arsenic, 164 

constitutional effects of, 167 

in childhood, 46 

in skin disease, toleration of, 40 

white, 104 
Arsenic-eating in Styria, 40, 170 
i Arsenici iodidum, 104 
| Arsenicum, 104 
Arsenious acid, 96, 164 
Ascaris lumbricoides, 60 
Aspidospermin, 468 
Assafcetida, 171 
Asthma cigarettes, 183 
Astringents and caustics, 68 
Atropia, 175 
Atropine sulphas, 175 
Aurantii amari cortex, 172 

dulcis cortex, 172 

fiores, 172 
Aurantium, 172 
Aurum, 449 
Avenae farina, 173 
Azedarach, 450 



BALSAM of Peru, 173 
of Tolu, 174 
Balsamum Peruvianum, 174 

Tolutanum, 174 
Barbadoes aloes, 137 
Barii carbonas, 174 

chloridum, 174 
Bark, cinchona, 226 
, Barley, 291 
Bath, nitric acid, 110 
Baths, therapeutic effects of, 156 
Bay rum, 420 
Bearberry, 434 
Bebeeru bark, 334 
i Belae fructus, 449 
Belladonna, 175 

effects on animals, 183 

effects on rabbits, 52 

in childhood, 45 

leaves, 175 

root, 175 



508 



GENERAL INDEX. 



Belladonna — 

poisoning, 175 
Belladonnas foliae, 175 

radix, 175 
Benzoate of ammonium, 184 
Benzoated lard, 181 
Benzoic acid, 184 
Benzoin, 184 
Benzoinum, 184 
Betel nut, 449 

Bichromate of potassium, 383 
Bismuth, 185 

subcarbonate of, 185 

subnitrate of, 185 
Bismuthi subcarbonas, 185 

subnitras, 185 
Bismuthum, 185 
Bitter almond, 147 
Bittersweet, 263 
Blackberry, 309 
Black draught, 413 
Black drop, 347 
Black hellebore, 291 
Black snakeroot, 226 
Black-wash, 296 
Blistering collodion, 242 

papers, 197 
Blisters, caution in use of, 200 

therapeutic indications for, 
200 
Bloodroot, 403 
Bone, 358 
Boneset tea, 269 
Boracic acid, 441 
Borax, 416 
Brandy, 420 
Brayera, 450 
Bromide acne, 387 
Bromide of ammonium, 186 
Bromide of potassium, 186 
Bromine, 186 
Brominium, 186 
Broom, 410 

Brown mixture, 93, 288 
Buchu, 187 
Buckthorn, 470 
Burgundy pitch, 369 
Burnett's disinfecting fluid, 

438 
Butternut, 317 
Butyl chloral-hydrate, 215 



CACAO butter, 345 
Cadmii sulphas, 188 
Cadmium, 188 
Caffea, 188 
Caffeine, 188 
Cajeput oil, 189 
Calabar bean, 364 
Calcii carbonas prgecipitata, 189 

chloridum, 189 

hypophosphis, 189 

phosphas praecipitata, 189 
Calcis hydras, 189 
Calcium, 189 
Calomel, 293 
Calumbo, 191 
Calx, 189 

Calx chlorinata, 189 
Camphor, 192 
Camphora, 192 
Canada fleabane, 269 
Canada pitch, 309 
Canada turpentine, 429 
Cauella. 195 
Canna, 195 

Cannabis Americana, 195 
Cannabis Indica, 195 
Cantharides, 197 
Cantharis, 197 
Cape aloes, 137 
Capsicum, 201 
Caraway, 204 
Carbo, 201 

animalis purificatus, 201 

ligni, 201 
Carbolic acid, 96 

ointment, 96 
Carbon, 201 
Carbonated waters, 159 
Cardamom, 203 
Cardamomum, 203 
Carrageen, 226 
Carron oil, ISO 
Carum, 294 
Caryophyllus, 204 
Casca bark, 452 
Cascarilla, 205 
Cassia fistula, 205 
Cassia Marilandica, 205 
Castillon's powders, 481 
Castor, 205 
Castoreum, 205 



GENERAL INDEX. 



f>09 



Castor oil. 343 
Cataria, 20G 
Catechu, 206 
Catnep, 206 

Caution in regard to arsenic in 
skin disease, 169, 170 

in regard to blisters, 200 

in regard to chloral, 213 

in regard to chloroform, 224 

in regard to opium in bron- 
chitis, 250 
Cayenne pepper, 201 
Cera alba, 207 

flava, 207 
Cerata, 207 
Cerate of cantharides, 107 

of extract of cantharides, 197 
Cerates, officiual, 206 
Ceratum, 123 

cantharidis, 197 

cetacei, 207 

extracti cantharidis, 197 

plumbi subacetatis, 193, 371 

resinse, 396 

resinas compositum, 321, 396 

sabinse, 401 

saponis, 407 

zinci carbonatis, 438 
Cerii oxalas, 207 
Cerium, 206 

oxalate, 207 
Cetaceum, 207 
Cetraria, 208 
Cevadilla, 400 
Chalk, 189, 252 
Chalk-lozenges, 189 
Chalybeate waters, 160 
Chamomile, 149 
Chamomile, German, 329 
Charcoal, purified animal, 201 

wood, 201 
Charta cantharidis, 197 

sinapis. 415 
Chartge, 208 
Chemical antidotes, 62 
Cheaopodium, 208 
Cherry-laurel leaves, 403 
Children, how to prescribe for, 45 
Children's diseases, pilocarpia 

in, 462 
Chimaphila, 208 
Chinoliu, 237 



Chiretta, 209 

Chloral, 209 

as an anesthetic, 210 

caution in bronchitis, 212 

contra indicated in heart dis- 
ease, 21 1 
Chloral-camphor, 215 
Chloral hydrate, 209 
Chloric ether, 226 
Chloride of ammonium, 142 
Chloride of calcium, 189 
Chlorinated lime, 189 
Chlorine, 217 
Chlorine water, 217 
Chlorinum, 217 
Chloroform, 218 

how to give, 224 
Chloroformum, 218 
Chloroformum purificatum, 218 

venale, 218 
Cholagogue purgatives, 82 
Cholagogues, emetics as, 75 
Cholera mixture, 194 
Chondrus, 226 
Chorea, toleration of sulphate of 

zinc in, 41 
Chromic acid, 100 
Chrysophanic acid, 397, 458 
Cimicifuga, 226 
Cinchona, 226 
Cinchona flava, 226 

pallida, 227 

rubra. 22/ 
Cinchona-red, 236 
Cinchonia, 236 
Cinchonire sulphas, 227 
Cinchonidia, 237 
Cinnamomum, 238 
Cinnamon, 238 
Citric acid, 101 
Citrine ointment, 293 
Classification of drugs, 91 
Clover on anaesthetics, 58 

on chloroform, 222, 223, 225 
Cloves. 204 
Coca, 188 

Cocculus indicus, 452 
I Coccus, 239 
Cochineal, 239 
Codeia, 357 
I Cod-liver oil, 339 

inunctions, 339 



43* 



510 



GENERAL INDEX, 



Cod liver oil — 

when to give, 35 
Coffee, 188 
Colchiceine, 242 
Colchici radix, 239 

semen, 239 
Colchicia, 240 
Colchicum, 239 
Cold affusions, 157 
Cold baths in fever, 157 
Cold pack, 157 
Cold cream, 398 
Collodion, 242, 289 
Collodium, 242, 289 
Collodium cum cantharide, 197 
Collodium flexile, 289 
Colocynth, 243 
Colocynthis, 243 
Columbo, 191 
Combination of drugs. 32 
Compound cathartic pills, 293 
Compound spirit of ether, 135 
Confectio aromatica, 239 

aurantii corticis, 172 

opii, 347 

rosse, 398 

sennee, 413 
Confection of orange peel, 172 
Confectioues, 244 
Confections, officinal, 244 
Congress-spring water, 159 
Conii folia, 244 

fructus, 244 
Conium, 244 
Constitutional effects from small 

doses, 41 
Copaiba, 248 
Copper, 253 
Coptis, 251 
Coriander, 251 
Coriandrum, 251 
Cornus Florida, 252 
Corrosive sublimate, 293 
Cosmoline, 467 
Cotton, 289 
Cotton-root bark, 288 
Cough-medicines, how combined, 

33 
Counter-irritants, 69 
Counter-irritation, theory of, 69 
Court-plaster, 307 
Cranesbill, 286 



Cream of tartar, 378 
Creasote, 252 
Creasotum, 252 
Creta, 189, 252 
Creta proeparata, 189 
Crocus, 252 
Croton-chloral, 215 
Croton oil, 345 
Cryptopia, 357 
Cubeb, 253 
Cubeba, 253 
Culver's root, 319 
Cupri subacetas, 253 

sulphas, 253 
Cuprum, 253 

Cuprum ammoniatum, 142, 253 
Curare, 453 
Curcuma, 455 
Cusparia, 148 
Cyanide of mercury, 102 

of potassium, 102 

of silver, 102 



DATURIA, 421 
Deadly nightshade, 175 
Decocta, 256 
Decoction of aloes, 139 

of Zitmann, 303 
Decoctions, officinal, 256 
Decoctum cetrarire, 208 

chimaphilEe, 208 

cinchona flavoe, 227 

cinchona rubra, 227 

cornus Florida, 252 

dulcamara, 263 

hamatoxyli, 290 

hordei, 291 

quercus alba, 395 

sarsaparilla compositum, 407 

senega, 412 

uvfB ursi, 434 

Zittmanni, 303 
Deodorized tincture of opium, 

348 
Diachylon ointment, 370 
Diachylon ointment (improved), 

372 
Diagnosis between cholera and 
arsenical poisoning, 163 

of opium poisoning, 348 
Dialyzed iron, 463 



GENERAL INDEX. 



511 



Diaphoretics, notion of, 76 

classes of, 76 
Digitalinum, 256 
Digitalis, 256 

accumulation of, 41 

hints on prescribing, 41 

toleration of, 40 
Dilute acetic acid, 94 

alcohol, 127 

hydrocyanic acid, 102 

nitric acid, 109 

nitro-muriatic acid, 110 

phosphoric acid, 112 

sulphuric acid, 112 
Diseases from drinking water, 158 
Disguising taste of drugs, 47 
Disinfectant, chlorine as a, 217 
Disinfectants, antiseptics and, 66 

classes of, 66 

definition of, 67 

theory of, 66 
Distilled vinegar, 94 

water, 155 
Diuretic, copaiba as a, 249 

effect of digitalis, 261 
Diuretics, action of, 71 

classes of, 71 

how to aid, 33 
Dogwood, 252 
Donovan's solution, 164 
Dosage, 36 

Dose, action of drugs altered with, 
37 

constitutional effects from 
small, 41 

exceptions to rule, 51 

for children, 46, 47 

general observations upon, 49 

general rule for, 50 

interval between, 38 

of medicines, 36 
Dosing, principles of, 35 
Dover's powder. 311 
Drastic purgatives, 81 
Dried alum, 139 

Drugs, chemical and physiologi- 
cal incompatibilities of, 41 

classification of, 91 

combination of, 32 

proper time of giving, 34 
Duboisia, 455 
Dulcamara, 263 



IjURTH as a disinfectant, 67 
a Ecbolics, action of, 7") 
Effervescing draughts, 101 
Egsc, 358 
Elaterin, 263 
Elaterium, 263 
Elder, 403 

Elixir of cinchona flava, 237 
Elixir of jaborandi, 458 
Emetia. 315 
Emetic action of copper, 255 

alum, 140 

antimony, 150 

apomoi-phia, 357 

chamomile tea, 149 

mustard, 415 
Emetics, action of, 73 

as antidotes. 62 

as cholagogues, 75 

direct, 74 

effects on circulation of, 74 

effects on nervous system, 74 

effects on secretion of. 75 

free perspiration caused by, 75 

indirect, 73 
Emmeuagogue. aloes as an, 138 

cimicifuga, 226 

cotton-root bark, 288 
Emmenagogues and Ecbolics, 75 

direct. 75 

indirect, 76 
Emplastra, 264 
Emplastrum aconiti, 118 

am m miaci, 141 

ammoniaci cum hydrargyro, 
141, 292 

antimonii, 150 

arnicas, 162 

a«saf'oetida3, 171 

belladonnas, 175 

ferri, 272 

galbani cr.mpositum, 279 

hydrargyri, 292 

opii. 347 

picis Burgundicse, '-U',9 

picis Canadensis, 369 

picis cum cautharide, 197 

plumbi, 370 

resinae, 396 

saponis, 407 
Emulsion of cod-liver oil,:; 11 
Endennic medication. 27 



512 



GENERAL INDEX. 



Enemata, nutritive, 29 
purgative, 28 

Epidermic medication, 20 

Epsom salt, 326 

Ei-got of rye, 264 

Ergot, wine of, 264 

Ergota, 264 

Ergotine, 264 

Ergotism, 265, 267 

Eiigeron, 269 
Canadense, 269 

Erysipelas caused by arnica, 163 

Eruption of copaiba, 250 

Eserine, 367 

Ether, 124 

Ethereal oil, 339 

Ethers, officinal, 127 

Ethidene dichloride, 451 

Ethyl bromide, 451 

Eucalyptus, 456 

Eucalyptus globulus, 456 

Eupatorium, 269 

European worm-seed, 404 

Expectorants, 76 

Extracta, 270 

Extracts, officinal, 270 

Extractum aconiti, 118 
arnicas, 162 
belladonnas, 175 
belladonnae alcoholicum, 175 
belladonnas radicis fluidum, 175 
buchu fluidum, 187 
calumbas fluidum, 191 
cannabis Americans, 195 
cannabis Indices, 195 
chimaphilas fluidum, 208 
cimicifugae fluidum, 226 
cinchonas, 227 
cinchonas fluidum, 227 
colchici aceticum, 240 
colchici radicis fluidum, 239 
colchici seminis fluidum, 239 
colocynthidis, 243 
colocynthidis compositum, 203, 

243, 409 
conii, 244 

conii alcoholicum, 244 
conii fructus fluidum, 244 
cornus Floridae fluidum, 252 
cubebae fluidum, 253 
digitalis, 256 
diaitalis fluidum, 256 



Extractum — 

dulcamaras, 263 

dulcamaras fluidum, 263 

ergotas fluidum, 264 

erigerontis Canadensis fluidum, 
269 

gelsemii fluidum, 283 

gentianae, 285 

genthinas fluidum, 286 

geranii fluidum, 286 

glycyrrhizae, 288 

glycyrrhizae fluidum, 288 

gossypii radicis fluidum, 288 

haematoxyli, 290 

hellebori, 291 

hydrastis fluidum, 304 

hyoscyami, 304 

hyoscyami alcoholicum. 301 

hyoscyami fluidum, 305 

iguatias,- 307 

ipecacuanha? fluidum, 311 
jalapse, 316 
juglandis, 317 

krameriae, 318 

krameriae fluidum, 318 

lupuliuae fluidum, 292 
matico fluidum, 329 
mezerei fluidum, 331 
nucis vomica?, 334 
opii, 347 

pareirae fluidum, 358 
physostigmatis, 364 
pinus Canadensis fluidum, 369 
podophylli, 375 
pruni Virginianse fluidum, 393 
quassias, 395 
rhei, 396 
rhei fluidum, 396 
rubi fluidum, 399 
sabinae fluidum, 401 
sarsaparillse compositum fluid- 
um, 331, 408 
sarsaparillae fluidum, 407 
scillaB fluidum, 410 
senegae, 412 
senegae fluidum, 412 
sennas fluidum, 413 
"serpen tariae fluidum, 414 
spigelian fluidum, 419 
spigeliae et sennas fluidum, 419 
stillingia fluidum, 421 
stramonii foliorum, 421 



GENERAL INDEX. 



f>13 



Extractum — 

stramonii seminis, 421 
taraxaci, 428 
taraxaci fluidum, 428 
uvae ursi fluidum, 434 
Valerianae, 434 
Valerianae fluidum, 434 
veratri viridis fluidum, 436 
zingiberis fluidum, 440 



IMRINA tritici, 456 
Fel bovinum purificatum, 457 
Fennel, 278 
Fermentum, 271 
Ferri bromidum, 272 

chloridum, 271 

citras, 271 

dialysatus, liquor, 463 

et ammonii citras, 142, 271 

et ammonii sulphas, 142, 271 

et ammonii tartras, 116, 142, 
271 

et potassii tartras, 271 

et quiniae citras, 271 

et strychniae citras, 271 

ferrocyanidum, 90, 271 

hypophosphis, 271 

lactas, 94, 271 

oxalas, 271 

oxidum hydratum, 271 

phosphas, 271 

pyrophosphas, 272 

subcarbonas, 272 

sulpbas, 272 

sulphas exsiccata, 272 

sulphuretum, 271 
Ferrum, 271 

redactum, 272 
Ficus, 277 
Fig, 277 
Filix mas, 277 
Flaxseed, 321 
Fleabane, 269 
Fleming's tincture, 118 
Flour, 456 

Fluid extract Canada spruce, 369 
Fly- blisters, 199 
Fceniculum, 278 

Form of administering drugs, 34 
Fowler's solution, 164 
Foxglove, 256 



Fuchsine, 457 
Fusel oil, 136 



&ALBANUM, 279 
Gallse, 279 

Gamboge, 281 
Gambogia, 281 
Garlic, 136 
Gaultheria, 283 
Gelsemia, 283 
Gelsemium, 283 
Gentian, 285 
Gentiana, 285 
Geranium, 286 
German chamomile, 329 

tea, 93 
Gin, 127 
Ginger, 440 
Glauber's salt, 417 
Glycerina, 286 
Glycerine, 286 
Glycerita, 287 
Glycerites, officinal, 287 
Glyceritum acidi carbolici, 96 

acidi gallici, 279 

acidi tannici, 115, 279 

picis liquidse, 3<i9 

sodii boratis, 416 
Glycyrrhiza, 288 
Goa powder, 458 
Gold, 449 
Goldthread, 251 
Gossypii radicis cortex, 288 
Gossypium, 289 
Goulard's cerate, 193 

extract, 371 
Granati fructus cortex, 394 

radicis cortex, 394 
Greenhow's formula for gouty 

bronchitis, 241 
Green soap, 407 
Gregory's powder, 397 
Griffith's mixture, 276 
Gross, Prof., treatment of chloro- 
form poisoning, 219 
Guaiac, 289 
Guaiaci lignum, 289 

resin ae, 289 
Guaiacum, 289 
Guarana, 188 
Gum arabic. 93 



514 



GENERAL INDEX. 



Gun cotton, 242, 289 
Gutta percha, 290 



HABIT, doses affected by, -38 
Iliematoxylon, 290 
Hal ford, ammonia injection for 

snake-bites, 146 
Hammond's pill, 363 
Heart disease caused by tobacco, 
426 

cro ton-chloral contra- indicated 
in, 216 
Heat as a disinfectant, 67 
Hedeoma, 291 
Hellebore, white, 43-3 

American, 43-3 
Helleborus, 291 
Hemlock, 244 

spruce, 369 
Hemp, American, 195 

Indian, 195 
Henbane, 304 
Hiera picra, 137, 195 
Hirodo, 472 

Hoffmann's anodyne, 135 
Honey, 330 
Honeys, officinal, 330 
Hop-pillow, 292 
Hops, 292 
Hordeum, 291 
Horehound, 329 
Horsemint, 330 
Humulus, 292 
Huuyadi Janos water, 160 
Huxham's tincture, 237 
Hydragogue purgatives, 82 
Hydrargyrum ammoniatum, 293 
Hydrargyri chloridum corrosi- 

vum, 293 
Hydrargyri chloridum mite, 293 

idiosyncrasy in regard to, 38 
Hydrargyri cyanidum, 102, 293 
Hydrargyri iodidum rubrum, 293 

iodidum viride, 293 
Hydrargyri oxidum flavum, 292 

oxidum rubrum, 292 
Hydrargyri sulphas flava, 293 

sulphuretum rubrum, 293 
Hydrargyrum, 292 

ammoniatum, 142 
Hydrargyrum cum creta, 190, 292 



Hydrastis, 304 
Hydrated lime, 189 

oxide of iron, 276 
Hydriodio acid, 310 
Hydrochloric acid, 107 
Hydrocyanic acid, 102 
Hydrocyanic acid in oil of bitter 

almonds, 148 
Hydropathic treatment, 157 
Hyoscyami folia, 301 

semen. 304 
Hyoscyamia, 305 
Hyoscyamus, 304 
Hypodermic injection of apomor- 
phia, 357 

of atropia and opium, 356 

of Lugol's solutiou, 309 

of mercury, 302 

of morphia, 357 

of quinia, 27 

of strychnia, 27, 337 
Hypodermic medication, 27 
Ilypophosphite of lime, 191 



TCE for relieving pain, 158 
1 Iceland moss, 208 

Icthyocolla, 307 

Idiosyncrasy, 38 

in regard to calomel, 38, 39 
in regard to opium, 38 
in regard to quinine, 38 

Ignatia. 307 

Impurities of water, 155 

Incompatibilities, chemical and 
physiological, 42, 43 

Incompatibility of caustic alka- 
lies and alkaloids, 42 
of drugs, 44 

of iodide of potassium and cor- 
rosive sublimate, 44 
of iron and cinchona, 44 
of strychnia and Calabar bean, 
44 

Incompatibles of iodine, 308 

Incompatibles, special, 44 

Indian bael, 450 

Individual peculiarities, 37 

Infusa, 307 

Infusions, officinal, 307 

Infusum anthemidis, 149 
buchu, 187 



GENERAL INDEX. 



515 



Infusum — 

calumbse, 191 

capsici, "201 

caryophylli, 204 

cascarillse, 205 

catechu compositum, 206 

cinchonas flavse, 227 

cinchonse rubrce, 227 

digitalis, 256 

eupatorii, 269 

gentianse compositum, 173, 28( 

humuli, 292 

juniperi, 317 

kramerise, 318 

lini compositum, 321 

pareira, 358 

picis liquidse, 369 

pruni Virginiange, 393 

quassise, 395 

rhei, 396 

rosoe compositum, 398 

salvia, 403 

sennoa, 413 

serpentarise, 414 

spigeliee, 419 

tabaci, 425 

taraxaci, 428 

Valerianae, 434 

zingiberis, 440 
Inhalation, 28 

of ether, 126 
Interval between closes, 37 
Intravenous injection, 28 

of chloral, 210 
Introduction, 25 

Inunction of mercury in con- 
genita] syphilis, 299, 301 
Iodine, 308 
Iodinium, 308 
Iodism, 391 

to prevent, 34 
Iodoform, 310 
Iodoform um, 310 
Ipecacuanha, 311 

toleration of, in dysentery, 40 
Irish moss, ^26 
Iron, 271 
Isinglass, 307 



JABORANDI, 458 
Jalap, 316 



Jalapa. 316 

James's powder, 153 

Jamestown weed, 421 

Jervia, 437 

Johnson, Dr. Geo., treatment of 

diarrhoea, 343 
Juglans, 31 7 
Juices, officinal, 244 
Juniper, 317 
Juniperus, 317 



150 



KAMALA, 470 
Kermes mineral, 
Kinic acid, 236 
Kino, 318 
Kinovin, 236 
Kousso, 450 
Krameria, 318 



| AB4,RRAQUE r S solution, 417 
Lj Lactate of iron, 107 
Lactic acid. 107 

Lactophosphate of lime and cod- 
liver oil, 342 
Lactucarium, 319 
Larch-bark, 463 
Lard, 123 
Laricis cortex, 463 
Laudanum, 347 

in infancy, 46 
Laughing-gas. 465 
Laurocerasi folia, 463 
Lavandula, 319 
Lavender, 319 

Laxative effects of water, 158 
Laxatives, 81 
Lead, 370 

in drinking-water, 158 

plaster, 371 

water, 371 
Ledoyen's disinfecting solution, 

371 
Leeches, 472 
Lemon, 320 

juice, 320 
Leptandra, 319 
Lettuce-opium, 319 
Licorice. 2>y 
Lime, 189 

water, 189 



516 



GENERAL INDEX. 



Limones, 320 
Limonis cortex, 320 

succus, 320 
Lini farina, 321 
Linimenta, 321 
Liniments, officinal, 321 
Linimentum aconiti, 118 

ammonite, 142 

calcis, 190, 321 

camphorae, 193 

cantharidis, 197 

chloroformi, 218 

plumbi subacetatis, 371 

saponis, 193, 407 

terebinthitue, 429 
Linseed meal, 321 

oil, 321 
Linum, 321 
Liquor ammonii acetatis, 142 

arsenici chloridi, 1(54 

arsenici et hydrargyri iodidi, 
164, 293, 308 

barii chloridum, 174 

calcii chloridi, 190 

calcis, 190 

ferri chloridi, 271 

ferri citratis, 271 

ferri dialysatus, 4G3 

ferri nitratis, 272 

ferri subsulphatls, 272 

ferri tersulphatis, 272 

gutta-perchns, 290 

hydrargyri nitratis, 293 

iodinii compositus, 308 

magnesii citratis, 326 

morphias sulphatis, 348 

plumbi subacetatis, 371 

plumbi subacetatis dilutus, 371 

potassee, o77 

potassi citratis, 377 

potassii arsenitis, 1G4, 377 

potassii permanganatis, 377 

sodae, 416 

sodas chlorinatae, 417 

sodii arseniatis, 164, 417 

zinci chloridi, 438 
Liquores, 325 
Liquors, officinal, 325 
Lister's antiseptic system, 98 
Lithii carbonas, 323 

citras, 323 
Lithium, 323 



Lobelia, 325 
Logwood, 290 
Lugol's solution, 308 
Lupulina, 292 
Lycopodium, 326 



MACE, 332 
Macis, 332 
Magnesia, 326 
.Magnesii carbonas, 326 

sulphas, 326 
Magnesium, 326 
Male fern, 277 
Malt extract, 292 
Manganese, 328 
Manganesii oxidum nigrum, 328 

sulphas, 328 
Manganesium, 328 
Manna, 328 
Maranta, 328 
Marble, 329 
Marjoram, 358 
Mavmor, 329 
Marrubium, 329 
Marshmallow, 139 
Marsh-rosemary, 420 
Marsh's test for arsenic, 165 
Mastic, 329 
Mastiche, 329 
Materia medica, primary list of, 

93 
Matico, 329 
Matricaria, 329 
May-apple, 375 
Meconine, 357 
Mel, 330 

despumatum, 330 

rosse, 398 

sodii boratis, 416 
Mellita, 330 
Mentha piperita, 330 

viridis, 330 
Mercurial baths in syphilis, 299, 
300 

fumigation, 300 
Mercurialization, 300 
Mercury, 292 
Methyl conia, 245 
Metric system, 482 

in medicine, 54, 485 
Mezereon, 331 



GENERAL INDEX. 



517 



Mezereum, 331 
Milk of almonds, 147 

of ammoniac, 141 

of assafoetida, 171 
Mineral waters, 159 
Mistura ammoniaci, 141 

amygdalae, 1 47 

assafoetidse, 171 

chloroformi, 193, 218 

cretse, 190 

ferri composita, 272 

glycyrrhizoe composita, 289 

potassii citratis, 320 
Misturae, 331 
Mixtures, officinal, 331 
Molasses, 402 
Monarda, 331 
Mori succus, 464 
Morphia, 348 
Morphia valerianas, 117 
Morphia) acetas, 348 

murias, 348 

sulphas, 348 
Moschus, 332 
Mouth-wash, thymol, 471 
Mucilages, officinal, 332 
Mucilagines, 332 
Mucilago acacire. 93 

sassafras medullse, 408 

tragacanthse, 432 

ulmi, 433 
Mulberry juice, 404 
Muriatic acid. 107 
Muscarin, 464 
Musk, 332 
Mustard, 414 

poultice, how to make, 416 
Mydriasis by belladonna, 177 

by hyoscyamus, 306 
Myristica, 332 
Myrrh, 333 
Myrrha, 333 



VTARCEIA, 357 
JLl Narcotics, 78 
Narcotics and Anodynes, 71 
Narcotina, 357 
Nectandra, 334 
Neroli water, 173 
Nicotia, 426 
Nitric acid, 109 
44 



Nitrite of amyl, 415 
Nitroglycerin, 464 
Nitroglycerinum, 464 
Nitro-muriatic acid, 110 
Nitrous oxide gas, 465 
Norwood's, Dr., tincture of ve- 

ratrum viride, 436 
Nutgall, 279 
Nutmeg, 332 
Nux vomica, 334 



OAK, 395 
Oat-meal, 173 
Oil of almonds, expressed, 147 
of amber, 344 

of American pennyroyal, 291 
of anise, 149 
of bergamot, 185 
of bitter almonds, 147 
of eajuput, 189 
of camphor. 192 
of Canada fleabane, 269 
of caraway. 204 
of castor, 343 
of chamomile, 149 
of cinnamon, 238 
of cloves, 204 
of cod-liver, 339 
of copaiva, 248 
of croton, 345 
of cubebs, 253 
of fennel,' 278 
of gaultheria, 283 
of horse-mint, 331 
of juniper, 317 
of lavender, 319 
of lemon, 320 
of linseed. 321 
of neroli, 173 
of nutmeg, 332 
of olive, 342 
of orange, 172 
of origanum, 358 
of peppermint, 331 
of pimento, 368 
of rose, 398 
of rosemary, 399 
of rue, 3U9 
of savin, 401 
of sassafras, 408 
of spearmint, 331 



518 



GENERAL INDEX. 



Oil — 

of spruce, 369 

of sweet almonds, 147 

of tobacco, 425 

of turpentine, 429 

of theobroma, 345 

of thyme, 345 

of valerian, 435 

of wormseed, 208 
Oils, officinal, 338 
Ointments, 433 
Olea, 338 
Oleo-resinae, 339 
Oleo resinae capsici, 201 

cubebae, 253 

filicis, 277 

lupulinae, 292 

piperis, 3(38 

zingibens, 440 
Oleo-resins, officinal, 39G 
Oleum aethereum, 339 

amygdalae amarae, 147 

amygdalae expressum, 147 

anisi, 149 

anthemidis, 149 

bergamii, 185 

cajuputi, 189 

camphorae, 192 

cari, 204 

caryophilli, 204 

chenopodii, 2o8 

cinnamomi, 238 

copaihae, 248 

cubebae, 253 

erigerontis Canadensis, 2G9 

foeniculi, 278 

gaultheriae, 283 

hedeomae, 291 

juniperi, 317 

lavandulse, 319 

limonis, 319 

lini, 321 

menthaa piperitae, 330 

menthae viridis, 330 

monardae, 331 

morrhuae, 339 

myristicae, 332 

olivse, 342 

origani, 358 

pirnentae, 3G8 

ricini, 343 

rosse, 398 



Oleum — 

rosmarini, 399 

rutae, 399 

sabinae, 401 

sassafras, 408 

succini, 344 

succini rectificatum, 344 

tabaci, 425 

terebinthinae, 429 

theobromie, 345 

thymi, 345 

tiglii, 345 

Valerianae, 435 
Olive oil, 342 
Opium, 347 

effect on rabbits of, 52 

idiosyncrasy in regard to, 41 

in childhood, 4G 
Opodeldoc, 345 
Orange, 172 

flowers, 172 
Orange-peel, bitter, 172 

sweet, 172 
Orgeat syrup, 172 
Origanum, 358 
Os, 358 
Ovum, 358 

Oxalate of cerium, 207 
Oxalic acid, 11 1 
Ox-bile, 457 
Oyster-shell, 431 

prepared, 431 



PAIN relieved by counter-irri- 
tants, 69 
Painters' colic, 373 
Papaver, 358 
Papaverina, 358 
Paramorpbia, 358 
Parasiticides, 01 
Paregoric, 347 
Pareira, 358 
brava, 358 
Parsley, 467 
Partridge- berry, 283 
Pearl-ash, 377 
Peculiarities, individual, 38 
Pelletierine, 394 
Pennyroyal, American, 291 
Pepo, 359 
Pepper, 368 



GENERAL INDEX. 



519 



Peppermint, 330 
Pepsin, 465 
Pepsini porci, 465 
Peruvian bark, 226 
Petroleum, 466 
Petroselinum, 467 
Phosphoric acid, 1 12 
Phosphorus, 359 
Physiological antidotes, 63 
Physiology of vomiting, 74 
Physostigma, 364 
Picrotoxin, 452 
Pill, Guy's, 303 
Pills, officinal, 368 
Pilocarpia, 458 
Pilula ferri carhonatis, 272 

saponis composita, 407 
Pilule, 368 

aloes, 137 

aloes et assafcetidue, 137, 171 

aloes et mastiches, 137 

aloes et myrrhoe, 137, 333 

antimonii composite, 150, 293 

assafcetidre, 171 

catharticaa composite, 241, 293 

copaibae, 248 

ferri composite, 272 

ferri iodidi, 272, 308 

galbani compositce, 171, 279 

hydrargyri, 292 

opii, 347 

quinise sulphatis, 227 

rhei, 396 

rhei compositge, 137, 396 

scillte composite, 141, 409 
Pimenta, 368 
Timento, 368 
Pinkroot, 419 
Pinus Canadensis, 369 
Pinus palustris, 369 
Piper, 368 
Piperin, 368 
Pipsissewa, 208 
Pix Burgundica, 369 

Canadensis, 369 

liquida, 369 
Plaster, warming, 197 
Plasters, officinal, 264 
Plumbi acetas, 371 

carbonas, 371 

iodidum, 371 

nitras, 371 



Plumbi — 

oxidum, 370 
Plumbum, 370 
Podophyllin, 375 
Podophyllum, 375 
Poisoning, 61,474 (see Index of 
Diseases and Table of Poi- 
sons) 

by acids, 58 

by aconite, 1 18 

by alcohol, 128 

by ammonia, 142 

by amy lie alcohol, 136 

by antimony, 150 

by arsenic, 164, 165 

by barium, 174 

by belladonna, 182 

by bichromate of potassium, 
384 

by bitter almonds, 148 

by cantharides, 197 

by carbolic acid, ( .>7 

by chloral, 209, 212 

by chloroform, 219, 222 

by copper, 254 

by corrosive sublimate, 293 

by digitalis, 267 

by hemlock, 247 

by hydrocyanic acid, 102, 103 

by lead, 371 

by muriatic acid, 107 

by opium, 348 

by oxalic acid, 1 1 1 

by phosphorus, 362 

by physostigma, 367 

by pctassa, 378 

by santonin, 406 

by soda, 417 

by strychnia, 335 

by sulphuric acid, 1 13 

by tartar emetic, 150 

by tartaric acid, 1 16 

by tobacco, 425 

by veratria, 400 

vegetable, 477 
Poisons, 474 

table of, 474 

tests for, 480 
Pomegranate, 394 
Poppy capsules, 308 
Port wine, 1 L'7 
Potassa, 376 



520 



GENERAL INDEX. 



Potassa-alum, 376 

Potassa cum calce, 190, 376 

with lime, 376 
Potassii acetas, 376 

bicarbonas, 377 

bichromas, 377, 383 

bitartras, 377 

bromidum, 186, 377, 384 

carbonas, 377 

carbonas impura, 377 
pura, 377 

chloras, 377 

citras, 377 

cyanidum, 377 

et sodii tartras, 378 

ferrocyanidum, 102, 272, 377 

hypophosphis, 378 

iodidum, 377, 388 

nitras, 378 

permanganas, 378 

sulphas, 378 

sulphis, 378, 422 

sulphuretum, 378 

tartras, 378 
Potassium, 376 
Potassium bromide, 284 
Potassium iodide eruptions, 391 
Powders, officinal, 394 
Precipitated carbonate of lime, 
189 

phosphate of lime, 189 
Prepared chalk, 189 
Prescribing, rules for, 30 

for children, 45 
Prescription writing, 48 
Prescriptions, for combining: 

alum, 140 

arsenic, 171 

ammonium, acetate of, 147 
carbonate of, 146 
chloride of, 147 

benzoin, 184 

bismuth, 186 

capsicum, 201 

carbolic acid, 98 

castor oil, 344 

catechu, 206 

cerium, oxalate of, 207 

chloral, 215 

cod liver oil, 342 

colchicum, 241 

columbo, 192 



Prescriptions — 

conia (hypodermic), 248 

copaiva, 251 

croton oil, 347 

digitalis, 262 

ergot, 268 

fern-oil, 278 

gallic acid, 280 

garlic, syrup of, 137 

haematoxylon, 291 

hydrocyanic acid, 106 

hyoscyamia, 305 

hyoscyamus, 305 

Indian hemp, 197 

iron, 277 

juniper, 318 

liquor ammonii acetatis, 147 

magnesia, 327 

male fern, 278 

mercury, 302 

myrrh, 334 

nitric acid, 110 

nitro-muriatic acid, 111 

oil of amber, 344 

opium, 355 

podophyllin, 376 

potash salts, 383 

potassium, bromide of, 387 
iodide of, 393 

quinia, 235 

rhubarb, 398 

salicylic acid, 445 

scoparius, 411 

senega, 413 

soda, 418 

sodium, salicylate of, 438 

strychnia, 33*8 

sulphuric acid, 114 

taraxacum, 428 

tartar emetic, 154 

thymol, 471 

turpentine, 431 

zinc salts, 439 
Prescriptions, how to write, 30, 

48 
Proper time for exhibiting drugs, 

34 
Prunes, 393 
Prunum, 393 
Prunus Virginiange, 393 
Prussian blue, 271 
Ptomaines, 480 



GENERAL INDEX. 



521 



Pulveres, 394 

effervescentes, 116 

effervescentes aperientes, 116 
Pulvis aloes et canellse, 35, 195 

aroniaticus, 203, 238 

ipecacuanhas comp., 311 

jalapse compositus, 316 

rhei compositus, 396 
Pumpkin-seeds, 359 
Punica granatum, 394 
Purgatives, action of, 81 

classes of, 81 

combination of, 35 

for children, 46 

when to be given, 35 
Purging cassia, 205 
Purified aloes, 137 

ox-bile, 457 
Pyroxylon, 242, 289 



QUASSIA, 390 
Quebracho, 468 
Queen's root, 421 
Quercus alba, 395 

tinctoria, 395 
Quicklime, 189 
Quinia, administration of, 234 

idiosyncrasy in regard to, 39 

sulphas, 234 

valerianas, 117, 136 
Quinic acid, 236 
Quinidia, 236 
Quiuo-tannic acid, 236 



RAISINS, 434 
Red saunders, 404 
Refrigerants, antipyretics and 
Reinsch's test for arsenic, 154 
Remedies, certain classes of, 55 

officinal, x 
Resin, 396 
Resina, 396 

jalapae, 316 

podophylli, 375 

scammonii, 409 
Resinse, 396 
Resins, officinal, 396 
Resorciu, 470 
Rhamni succus, 470 
Rhatany, 318 



Rheum, 396 
llhigolene, 467 
Rhubarb, 396 
Rochelle salt, 377 
Rosa centifolia, 398 

gallica, 398 
Rose, 398 
Rosemary, 399 
Rosmarinus, 399 
Rottlera, 470 
Routes by which medicines enter 

the circulation, 24 
Rubus, 394 
Rue, 399 

Rules for prescribing, 29 
Ruta, 399 



SABA] 
Sal 



DILL A, 400 
ibiua, 401 
Saccharum, 402 

lactis, 402 
Saffron, 252 
Sage, 403 
Sago, 402 
Salicin, 470 
Salicylic acid, 443 
Saline purgatives, 82 

waters, 159 
Salivation, mercurial, 300 
Salvia, 403 
Sambucus, 403 
Sanguinaria, 403 
Sanguisuga officinalis, 472 
Santalum, 404 
Santonica, 404 
Santoninum, 404 
Sapo, 407 
63 j viridis, 407 

Saratoga water, 159 
Sarsaparilla, 407 
Sassafras, 408 

medulla, 408 
Savine, 401 
Scammonium, 409 
Scammony, 409 
Scheele's solution, 101 
Scilla, 409 
Scoparius, 410 
Scudamore's mixture, 211 
Seidlitz powders, 417 
Seltzer water, 159 

44* 



522 



GENERAL INDEX. 



Senega, 412 
Seneka, 412 
Senna, 413 

American, 205 
Serpentaria, 414 
Sevum, 414 
Sherry wine, 127 
Silver, 160 

cyanide of, 160 

fused nitrate of, 161 

in surgery, 161 

nitrate of, 161 

oxide of, 161 

pills of nitrate of, liable to ex- 
plode, 165 

toleration of, 162 
Sinapis alba, 414 

nigra, 414 
Skin-discoloration from silver 

salts, 162 
Slippery elm, 433 
Snakeroot, 414 
Soap, 407 

Socotrine aloes, 137 
Soda, 417 

mint, 419 

powders, 116 
Sodii acetas, 416 

arsenias, 104, 416 

bicarbonas, 416 

bicarbonas venalis, 416 

boras, 416 

carbonas, 416 

carbonas exsiccata, 416 

chloridum, 416 

hypophosphis, 417 

byposulphis, 417, 422 

nitras, 417 

phosphas, 417 

salicylas, 443 

sulphas, 417 

sulphis, 417, 422 
Sodium, 417 

Solution of acetate of ammonium, 
142 

dialyzed iron, 463 

of arseniate of sodium, 164 

of arsenite of potassium, 377 

of chloride of arsenic, 164 

of chloride of barium, 174 

of chloride of lime, 196 



Solution — 

of iodide of arsenic and mer- 
cury, 164, 293, 308 

of lime, 196 

of nitrate of iron, 272 

of nitrate of mercury, 293 

of permanganate of potassium, 
378 

of persulphate of iron, 372 

of potassa, 272 

of soda, 417 

of subacetate of lead, 371 

of subsulphate of iron, 272 

of sulphate of morphia, 345 

of tersulphate of iron, 272 
Solution, MonsePs, 272 
Spanish-fly, 197 
Spearmint, 331 
Specific action of quinia, 232 
Spermaceti, 207 

cerate, 207 
Spice plaster, 204 
Spigelia, 419 
Spirit of ammonia, 142 

of ammonia, aromatic, 142 

of camphor, 193 
Spirits, officinal, 420 
Spiritus aetheris compositus, 124, 
135 

aetheris nitrosi, 135 

ammoniae, 142 

atnmonifi aromaticus, 142, 146, 
320 

anisi, 149 

camphorce, 193 

chloroformi, 218 

cinnamomi, 239 

frumenti, 127, 420 

Genevae, 127 

juniperi, 317 

juniperi compositus, 127, 317 

Lavandulae, 319 

lavandulae compositus, 319 

limonis, 320 

mentbae piperitae, 330 

menthae viridis, 330 

myrciae, 127, 420 

myristicae, 332 

saponis kalinis, 407 

vini Gallici, 127, 420 
Spurred rye, 264 - 



GENERAL INDEX. 



23 



Squill, 409 
Starch, 148 

of canna, 195 
Statice, 420 
Stillingia, 421 
Stimulants, alcoholic, 127 
Stimulants and sedatives, 84 
Stomach-pump, caution in regard 

to, 62 
Storax, 422 
Stramonii folia, 421 
Stramonii semen, 421 
Stramonium, 421 
Strong alcohol, 127 
Stronger aether, 124 
Strychnia, 334 

eaten by pigeons, 52 

hints on prescribing, 42 

injections, 3o6 
Strychnia? sulphas, 334 
Strychnos ignatia, 334 

nux vomica, 334 
Styptic colloid, 242 
Styrax, 422 

Styria, arsenic eating in, 40, 168 
Succi, 422 
Succus conii, 244 

taraxaci, 428 
Suet, 414 
Sugar. 402 

of lead, 371 

of milk, 402 
Sulphate of atropia, 175 

of morphia, 348 
Sulphur, 422 

lotum, 422 

prascipitatum, 422 

sublimatum, 422 
Sulphurated antimony, 150 
Sulphuret of antimony, 150 
Sulphuretted waters, 159 
Sulphuric acid, 112 
Sulphuris iodidum, 422 
Sulphurous acid, 112 
Sumbul, 470 

Summary of Action of Drugs, 90 
Suppositoria. 345, 424 

acidi carbolici, 96 

acidi tannici, 116, 279 

aloes, 138 

assafcetida?, 171 

belladonnas, 175 



Suppositoria — 

morphias, 348 

opii, 348 

plumbi, 371 

plumbi et opii, 348, 371 
Suppositories, 29, 845 

aloes, 138 

assafcetida, 171 

belladonna, 175 

carbolic acid, 96 

officinal, 424 
Sweet almond, 147 
Sweet spirit of nitre, 135 
Syrup, orgeat, 172 
Syrupi, 425 
Syrups, officinal, 425 
Syrupus, 412 

acacias, 93 

acidi citrici, 101, 320 

allii, 136 

amygdala?, 147 

aurantii corticis, 172 
florum, 172 

ferri iodidi, 272, 308 

fuscus, 402 

ipecacuanha?, 311 

krarneria?, •'! 1 S 

lactucarii, 319 

limonis, 320 

papaveris, 358 

pruni Yirginianse, 393 

rhei, 396 

aromaticus, 396 

rosas Gallicas, 398 

rubi, 399 

sarsaparillas compositum, 408 

scillas. 409 

compositus, 150, 409 

senega?. 41 2 

tolutanus, 174 

zingiberis, 440 



TAB A CUM, 4 25 
Table-salt, 416 
Taeniae, varieties of, 
Tamarind, 4'J7 _ 
j Tamarindus, 127 
Tannic acid, 1 15 
Tapioca, 428 
Tar. 369 
Taraxacum, 428 



5 '.i 



524 



GENERAL INDEX. 



Tartar emetic, 149 
Tartaric acid, 116 
Tartrate of antimony and potas- 
sium, 149 

of iron and ammonium, 150 
Tea, 188 
Tea berry, 283 
Temperature reduced by baths, 

156 
Terebintbina, 429 

Canadensis, 429 
Testa. 431 

prasparata, 189, 431 
Tests for alcohol, 128 

antimony, 150 

arsenic, 166 

atropia, 479 

barium, 174 

brucia, 335, 479 

conia, 244 

copper, 254 

sulphate of, 255 

delphinia, 479 

emetia, 479 

hydrocyanic acid, 102 

mercury, 294 

morphia, 479 

muriatic acid, 109 

oxalic acid, 112 

potassii bichromas, 384 

potassium, 356 

sodium, 417 

solauium, 479 

strychnia, 335, 479 

sulphuric acid, 113 

tannic acid, 116 

tartaric acid, 116 

veratria, 479 
Tetanus from hypodermic injec- 
tion, 27 
Thebaia, 357 
Theobroma, 345 

Therapeutic deductions from phy- 
siological experiments, 50 
Thieves' vinegar, 93 
Thoroughwort, 269 
Thymol, 471 

Time for exhibiting medicines, 34 
Tinctura aconiti radicis, 118 

aloes, 137 

aloes et myrrhae, 137, 333 

arnicse, 162 I 



Tinctura — 

assafcetidae, 171 

aurantii, 172 

belladonnae, 175 

benzoini, 184 

benzoini composita, 137, 174, 

184 
calumbae, 191 
cannabis, 196 
cantharidis, 197 
capsici, 201 
cardamomi, 204 

composita, 204 
castorei, 205 
catechu, 206 
cinchonas, 227 
colchici, 240 
composita, 172, 227 
cinnamomi, 238 
conii, 244 
cubebae, 253 
digitalis, 256 
ferri chloridi, 271 
galla3, 279 
gentianoe composita, 172, 204, 

286 
guaiaci, 289 

guaiaci ammoniata, 142, 289 
hellebori, 291 
humuli, 292 
hyoscyami, 305 
iodinii, 308 
iodinii composita, 308 
jalapae, 316 
kino, 318 
krameriae, 318 
lobelice, 324 
lupulinae, 291 
myrrhae, 333 
nucis vomicae, 334 
opii, 347 
opii ricetata, 347 
opii camphorata, 193, 347 
opii deodorata, 348 
quassiae, 395 
rhei, 214, 396 
rhei et sennae, 396, 413 
sanguinariae, 403 
scillae, 410 
serpentariae, 414 
strain onii, 421 
tolutana, 174 



GENERAL INDEX. 



525 



Tinctura — 

Valerianae, 434 

Valerianae ammoniata, 142, 434 

veratri viridis, 436 

zingiberis. 440 
Tincturse, 432 
Tincture of gelsemium, 283 
Tinctures, officinal, 432 
Tobacco, 425 
Tolerance of antimony, 41, 152 

of opium, 354 

of quinia, 232 

of zinc sulphate, 440 
Toleration of drugs, 41 
Tonics, 86 
Tragacanth, 432 
Tragacantha, 432 
Treatment of poisoning (see Anti- 
dote, and Index of Diseases) 
Trimethylamine, 471 

hydrocblorate of, 471 
Troches, officinal, 434 
Trocbisci, 434 

acidi tannici, 116, 279 

cretce, 190 

cubebas, 253 

ferri subcarbonatis, 272 

glycyrrhizas et opii, 288, 348 

ipecacuanlue. 311 

magnesias, 326 

menthas piperita, 336 

morphae et ipecacuanhas, 315, 
348 

potassii chloratis, 377 

santonini, 404 

sodii bicarbonatis, 417 

zingiberis, 440 
Turmeric, 455 
Turpentine, 429 
Turpeth mineral, 293 
Typhoid fever propagated by 

water, 159 



ULMU3, 433 
Unguenta, 433 
Unguentum, 123 
acidi carbolici, 96 
acidi tannici, 115, 279 
antimonii, 150 
aqi-ae rosse, 148, 398 
belladonnas, 175 



Unguentum — 

benzoini, 184 

cantharidis, 197 

crea.soti, 252 

gallas, 279 

hydrargyri, 292 

hydrargyri ammoniati, 293 

hydrargyri iodidi rubri, 293 

hydrargyri nitratis, 293 

hydrargyri oxidi fiavas, 292 

hydrargyri oxkli rubri, 292 

iodinii, 308 

iodinii compositum, 308 

mezerei, 331 

picis liquidas, 369 

plumbi carbonatis, 371 

plumbi iodidi, 371 

potassii iodidi, 377 

stramonii, 421 

sulphuris, 422 

sulphuris iodidi, 422 

tabaci, 425 

veratrias, 400 

zinci oxidi, 438 
Uva passa, 434 
Uva ursi, 434 



VALERIAN, 434 
V Valerianate of ammonia, 435 
Valerianic acid, 117, 434 
Vallet's mass, 272 
Vanilla, 435 
Vaseline, 467 
Veratralbia, 435 
Veratria, 400 
Veratroidia, 437 
Veratruai album, 435 

viride, 4 :i • * 
Verdigris, 253 
Vienna paste, 376 
Vina, 4:!7 
Vinegar, 94 
Vinum aloes, 138, 204 

antimonii, 150 

colchici radicis, 240 

colchici seminis, 240 

ergotas, 265 

ipecacuanhas, 31 1 

opii. 347 

Portense, 121 

rhei, 195, 397 



26 



GENERAL INDEX. 



yinum — 

tabaci, 425 

Xericum, 127 
Virginia snakeroot, 414 
Virginia Sulphur Springs, ICO 
Vomiting, physiology of, 74 

therapeutics of, 74 



WARBURG'S tincture, 236 
Warm bath in children's 
complaints, 159 
Warner's gout cordial, 435 
Water, 155 
ammonia, 142 
ammonia, stronger, 141 
anise, 149 
bitter, almond, 147 
camphor, 193 
classification of natural, 155, 

158 
hard and soft, 155 
orange-flower, 172 
Wax, 207 

Weights and measures, 48, 481 
Wheat flour, 456 
Whiskey, 420 



Wild cherry, 393 

Wine of tar, 369 

Wines, officinal, 437 

Wintergreen, 283 

Wistar's cough lozenges, 348 

Woorara, 453 

Wormseed, 208 

Wormwood, 93 

Wrist- drop, 374 



YEAST. 271 
Yellow jasmine, 283 



7 INC, 437 

L Zinci acetas, 438 

carbonas prcecipitata, 438 

chloridum, 438 

oxidum, 437 

oxidum venale, 437 

sulphas, 438 

sulphas, toleration of, 440 

valerianas, 117, 438 
Zincum, 437 
Zingiber, 440 
Zittman's decoction, 304 



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